Stop Loss

Specific Stop Loss

What it covers

Specific Stop Loss protects employers from claims that exceed a predetermined dollar amount (deductible) for any one covered individual. Once the Specific deductible has been reached, the Stop Loss policy reimburses an employer for covered medical expenses, helping to protect the employer’s bottom line.

Standard features

• Deductibles from $25,000 to $500,000
• Full range of claims bases
• Advance Risk Commitment – early lock-in for rates up to 90 days
• Simultaneous Reimbursement
• Integration with the Affordable Care Act (ACA)
• Medical management fees, such as case management, hospital audits, and bill negotiation, eligible for coverage
• ccSTAT® cost-containment services
• No signed disclosure at renewal

Options

• Aggregating Specific deductible
• Terminal Liability
• Renewal Risk Stabilizer – no new lasers at renewal with rate cap guarantee
• Transplant Risk Stabilizer – reduced deductible for transplant claims
• Policy Alignment
• Group Captive solutions

For more information, contact your Berkley Accident and Health representative.

 

Insurance coverage is underwritten by Berkley Life and Health Insurance Company and/or StarNet Insurance Company, both member companies of W. R. Berkley Corporation and both rated A+ (Superior) by A.M. Best. Not all products and services may be available in all jurisdictions, and the coverage provided is subject to the actual terms and conditions of the policies issued. Payment of claims under any insurance policy issued will only be made in full compliance with all United States economic or trade and sanction laws or regulation, including, but not limited to, sanctions, laws and regulations administered and enforced by the U.S. Treasury Department’s Office of Foreign Assets Control (“OFAC”).