Skip to main content
Medical Stop Loss

Medical Stop Loss

Top 190 independent medical stop loss

Highlights

  • Minimum group size of 50 lives
  • PPO, UR and large-case management program credits and referrals
  • Consultative pricing including credits for PPO, UR, large-case management programs, and alternative plan design solutions including Reference Based Pricing
  • Rate Stabilization policy endorsement (no New Laser with rate cap)
  • Market-competitive excess loss contract
  • Specific advance and expedited reimbursement options for ASO and TPA managed plans

Specific coverage

Customized stop loss is provided to address the employer's exposure to high-cost medical expenses on a covered individual.

  • Specific deductibles range from $25,000 to $2 million
  • Unlimited lifetime maximums
  • Contract basis: Gap-less, 12/12, 12/15, 12/18, 12/24, 15/12, 18/12, 24/12 and PAID
  • Coverage options available: medical, prescription drug

Aggregate coverage

Aggregate stop loss coverage limits the employer's overall annual cost for a self-funded plan. This coverage addresses the accumulation of expenses on all individuals (as opposed to high expenses for particular individuals).

  • Competitive attachment points
  • Per-policy period maximum available: $1 to $5 million
  • Contract basis: Gap-less, 12/12, 12/15, 12/18, 12/24, 15/12, 18/12, 24/12 and PAID
  • Coverage options available: medical, prescription drug, dental, vision and WDI

Claims, Risk Management, Cost Containment

QBE’s industry leading Claims, Risk Management, and Cost Containment teams are dedicated to helping our clients minimize the financial impact of claims, while preserving the quality of care for members. Our team of accomplished nurses continuously review and monitor potential and ongoing claims to identify cost savings opportunities. Once an opportunity for savings is identified, we collaborate with our clients to recommend cost containment solutions to preserve our client's plan assets.

Optional coverage

  • Aggregating specific
  • Specific terminal liability
  • Aggregate accommodation
  • Aggregate terminal liability
  • QBE Rewards: experience refund option

Value-added services

  • Consultative underwriting and marketing services
  • Internal claims re-pricing services
  • Risk management oversight programs
  • On-site technical and clinical expertise

Want to learn more?