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Stop-Loss Reinsurance

Stop-Loss Reinsurance
 

 

IPMG represents many Stop-Loss/Excess Reinsurance carriers. IPMG assists Brokers & Clients in finding both the right stop-loss carrier & policy to meet their specific needs.

IPMG has a solid relationship with several A+ stop-loss carriers that will enable you to select the perfect policy for your needs. Our stop-loss staff has over 75 years collective experience and is able to provide any assistance and guidance necessary.

IPMG is able to provide financial security for your company in the event of a catastrophic health issue affecting your employee(s) and their covered dependents. We continually monitor claims activity and stop-loss claims are filed on a weekly basis for our groups. This immediate process enables our clients to control their costs and to keep their health insurance budgets intact.

WHAT IS STOP/LOSS?

It is reinsurance for a self-funded plan, which an employee benefit plan buys (usually arranged by the TPA as a normal part of administration) as back-up insurance to stop the loss from unexpectedly high claims on the plan. Stop-Loss usually has two points at which it takes effect. The first is known as the "specific" attachment point. This applies to the cost of one claim or person. For instance, open heart surgery could prove an unexpectedly high expense, but it is only reflected in the expenses for a single individual. Thus, the "specific" attachment point might be set at an amount such as $25,000. That means that the regular fully-insured stop-loss reimbursements from a commercial insurance company would begin to reimburse the plan or employer for all charges for that claim above the attachment point. Important legal note: Stop-loss reimburses the plan or employer (depending how the contract is written). It is not insurance on the person.

The second Stop-Loss trigger is known as the "aggregate" attachment point. This applies to the total claims of the whole group. The stop-loss insurance policy begins to reimburse for claims when the total of all claims exceed some set amount. Stop-Loss is not mandatory. However, Stop-Loss provides a safety net which allows the risk of self-funding to be predictable, and has made self-funding practical for even tiny employers whose cash flow can budget for the possible losses.

TPAs work closely with leaders of the Stop-Loss industry to increase communication and understanding. This has tremendously smoothed the TPA/Stop-Loss/plan relationship & functioning.

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