Medical Plans with Stop-Loss

An employer that self-funds its medical benefits plan needs stop-loss insurance to protect it from larger than expected claims, whether for a single employee or its entire workforce. With stop-loss insurance, an employer will not be responsible for claims in excess of certain pre-set limits for the policy year. Once claims exceed these limits, the stop-loss carrier assumes the liability.

There are two types of stop-loss insurance:

Specific Stop-Loss Insurance, sometimes referred to as “individual stop-loss insurance”, protects an employer in the event that a single employee has larger than expected claims. This type of coverage reimburses the employer for claims made by an employee in excess of the policy’s per-employee deductible.

Aggregate Stop-Loss Insurance protects an employer from high claim volume. This type of coverage reimburses the employer in the event that the total claims of all employees exceed an overall deductible for the policy year.

While self-funding a medical benefits plan may make sense for a particular employer, stop-loss insurance is critical to protect the employer from catastrophic claims. If even one employee gets cancer or has surgery, the cost to the employer that self-funds medical benefits can be hundreds of thousands of dollars. This could be devastating to a small business. Stop-loss insurance protects the employer from such claims. With stop-loss insurance, an employer knows that its total cost cannot exceed a pre-determined amount.

To get a quote on Medical Stop-Loss, CLICK HERE for the application. For information on how to get a quicker and more accurate quote, CLICK HERE. Please email the completed application and all other required information to support@rmcgp.com. If you have any further questions, call RMC Group at 888.599.5553.