Medical Stop Loss Insurance
What is Medical Stop Loss insurance?
Medical Stop Loss Insurance (also known as excess insurance) can help protect organizations against unexpected surges in the healthcare costs of their plan participants. Stop loss coverage can be a key safeguard against catastrophic medical claims that could drain the financial reserves of a managed care organization or employer that self-funds its medical plan.
Zurich’s Medical Stop Loss Insurance provides a layer of protection that kicks in when medical expenses exceed a certain deductible, on a specific or aggregate basis. Our diverse products, broad coverage limits, specialized underwriting and flexible design help organizations provide the right coverage for their participants while budgeting more predictably…for greater peace of mind.
Why Zurich?
Customized to your plan
Our stop loss coverages defer to your benefits plan document to determine eligible claim expenses and enrollment eligibility. This avoids discrepancies, coverage gaps and unpleasant surprises.
Claims service
Zurich’s Claims service earns “Best in Class” scores from our customers.1 We work to minimize both the time and the information required for claims management and processing.
Budgeting tools
Enhanced renewal options include no new “laser” on individuals expected to have large claims (i.e., no exclusion of coverage or higher deductible for such individuals).
Medical Stop Loss Insurance Solutions
Employer Medical Stop Loss
This medical stop loss coverage reimburses qualified employers when medical claims exceed a certain dollar amount. It’s available as specific or aggregate coverage, based on claims of an individual plan participant or the entire group. In addition to medical stop loss plans, we offer employers:
- Integrated Stop Loss: An innovative bridge product for employers moving from a fully insured employee health plan to a self-funded one.
- Incurred Stop Loss: Reimburses any eligible claim incurred within the stop loss policy period, even if the claim is paid outside the stop loss policy period.
Managed Care Excess
This coverage reimburses a managed care organization (MCO), such as a health maintenance organization (HMO), when large claims exceed a certain dollar amount. It’s available on a specific and aggregate basis (individual and group).
Additional services
The following are also available to qualified customers:
- Broad-spectrum solutions customized for multiple exposures (Medical Malpractice, Property, Casualty, Patient Exposures)
- Clinical risk management resources and access to preferred cost containment vendors
- Direct access to underwriting, risk management and claims management
