Advancing self-funding together
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Managing a self-funded medical benefit plan is not without risk. Catastrophic individual claims or aggregate claims well in excess of expectations can drain the financial reserves of even the best-run plans. As we value feedback from you, our clients, we've developed a number of employer stop loss solutions with your needs in mind. We have a shared understanding of the risks associated with self-funding and are committed to addressing coverage gaps.
How we can help you
Further Information
Traditional stop loss products
Specific stop loss limits the employer’s eligible medical expenses for each covered individual. Aggregate stop loss limits the employer’s overall annual costs for a self-funded plan. This coverage addresses the accumulation of expenses of all covered individuals on the plan period.
Employer group captives
We collaborate with the industry’s leading captive managers to provide stop loss coverage to their captive members. These programs are able to provide all the advantages of a traditional self-funded program with less volatility. They allow employers a way to collectively reinsure their self-funded employee benefit plan and gain control over costs.
Swiss Re Corporate Solutions: Employer stop loss health insurance solutions - Product features
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Product features |
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Specific advanced funding Specific advanced funding is quoted for all cases at no additional cost. The specific deductible must be paid in full by the policyholder at least ten business days prior to the end of the specific benefit period and be greater than $1,000. |
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No new laser (NNL) Eligible groups with specific deductibles of $25,000 or higher and a minimum annual premium of $75,000 can purchase our NNL option. This option prevents new lasers from being applied at renewal and offers a standard specific rate increase of 50% on the same contract basis. |
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Experience refund feature On qualified stop loss policies, this option offers employer groups a greater comfort level with the cost of coverage, knowing that a percentage of premium may be returned to them if their specific stop loss claims costs are below expected. |
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Gapless renewal run-out feature Gapless renewal coverage provides additional specific and aggregate claim protection with respect to claims that were incurred during the prior contract period but paid after the run-out period. Claims that fall between the two contract periods can be a serious liability to employer health plans. The gapless option eliminates this liability for our clients that are currently on a run-out contract and renew. |
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Aggregating specific deductible (ASD) The ASD option is designed to allow clients to take on additional claims risk, in exchange for a lower premium, by self-funding a specific amount beyond the group's elected specific deductible. ASD in lieu of a laser is offered when there is a known risk. This option allows a group that has not had favorable claims an alternative to overall increase in premium or a traditional laser option. |
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Monthly aggregate accommodation This option provides that, if, at the end of a policy month, the group’s cumulative eligible expenses exceed the cumulative aggregate attachment point by an amount greater than $1,000, we'll reimburse the amount by which the cumulative eligible expenses exceed the cumulative aggregate, provided all policy provisions have been met. Coverage must be elected at the beginning of each policy period and is available for groups with less than 300 enrolled, larger groups may be considered upon request. |
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Terminal Liability Option TLO is offered as an option on specific and aggregate coverage. TLO provides a 3-month run-out period assuming all requirements are met and must be selected at the beginning of each policy period. Coverage is provided for eligible expenses not eligible for coverage under any other group policy. |
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Step-down deductible Our step-down deductible feature provides the client with a one-time reduction of their specific deductible during the policy period for eligible claimants. When clients partner with our selected cost containment providers to negotiate and apply an additional reduction to a claim as a result of engaging them, the step-down deductible is applied. |
Why choose us?
Further Information
Experience
Members of the Accident & Health team of Swiss Re Corporate Solutions have been providing in-depth product knowledge and solutions to customers for decades.
Expertise
Our team's long history and continuity in this market gives both our policyholders and their trusted advisors confidence in knowing they are backed by experts who adapt to market trends and provide market-leading capacity.
Financial strength
Coverage is underwritten by Swiss Re Corporate Solutions America Insurance Corporation, a direct writer for self-insured employer groups in all 50 states, as well as the District of Columbia, with a financial strength rating of (A+ Superior) by A.M. Best Company.
Want to learn more?
Visit our Accident & Health page or contact us!
Further Information
Disclaimer
Insurance products underwritten by Swiss Re Corporate Solutions America Insurance Corporation. Not all products or coverages may be available in all jurisdictions.
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John Fries
Richelle Austin
Ronald Nagy
