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
• ASO QuickPay  – rapid reimbursement available for ASO claims*
• Integration with the Affordable Care Act (ACA)
• Medical management fees, such as case management, hospital audits, and bill negotiation, eligible for coverage
• Berkley Edge cost-containment services
• No signed disclosure at renewal

*some exclusions may apply

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.