Medical stop loss coverage

 

Helping protect businesses from soaring healthcare costs

Controlling healthcare costs is a concern for any business – but larger-than-expected medical claims can devastate a self-funded employer. With medical stop loss insurance from Liberty Mutual, organizations can help protect their claims liability and bottom line.

Employer stop loss (ESL) insurance

Self-funded health benefit plans can give employers better flexibility and control over expenses, while providing important medical coverage to their employees. But with self-funding comes increased financial risk, including the possibility of medical claims that are larger, more complex, or more frequent than expected.

Anticipating and protecting against overwhelming medical claims isn't easy. It takes a trusted advisor who will be around for the long haul. With Liberty Mutual's employer stop loss coverage, employers can plan confidently for the future, without the worry of catastrophic medical expenses.

Our expert coverage options offered to self-funded employers include:

  • Specific excess loss
    • Incurred and paid, run-in and run-out contracts
    • Specific attachment points available from $20,000 (per state regulations) to $1,000,000
    • Eligible groups down to 50 covered lives (per state regulations)
    • Aggregating specific deductibles available
    • Coverage available in all states except WA
  • Aggregating excess loss
    • Incurred and paid, run-in and run-out contracts
    • Monthly aggregate accommodation available
    • Terminal liability option available
    • Nonexperience aggregates available on existing full insured employers

In-house clinical team and ProAct® Care Solutions

Because coverage isn't a one-size-fits-all solution, our stop loss clients enjoy the added advantage of our in-house clinical review teams and ProAct Care Solutions. Specialized to help contain costs, these benefits include:

  • A voluntary risk-management program that complements each client's individual stop loss coverage plan
  • The combined support of Liberty Mutual's industry-leading underwriting capabilities, best-in-class vendors, and an elite clinical team of on-staff nurses to help improve clinical outcomes and enhance care coordination
  • Access to transplant networks, case management for catastrophic claims, and specialty pharmacy management
  • Access to PPO networks, with supplemental contract negotiations and bill review, audit, and negotiation
  • Access to our robust in-house clinical review team offering expert guidance to producer partners and informed risk assessments

We also offer other medical stop loss options such as:

  • HMO reinsurance
    Helping HMOs manage growing financial risk associated with member care costs and curtail the impact of catastrophic claims
    • Specific retentions per member ranging from $75K up to $1.5M
    • Option for unlimited maximum benefit coverage per member
    • Up to $10M continuation of benefit coverage
    • Minimum premiums as low as $50K
    • Captive reinsurance options
  • Provider excess
    Supporting medical providers with an extra layer of protection. Whether your customer is a startup group or a well-established provider, this option can help protect against catastrophic claims.
    • Specific retentions per member ranging from $25K up to $1.5M
    • Option for unlimited maximum benefit coverage per member
    • Minimum premiums as low as $25K

Learn more

Contact your broker or Liberty Mutual to learn more about medical stop loss coverage for your business.

This is a general description of this program and/or service. See your policy, service contract, or program documentation for actual terms and conditions. Insurance is underwritten by Liberty Mutual Insurance Company or its affiliates or subsidiaries.

​Contact us

​Karthik Mohan
VP, Sales & Distribution
Liberty Mutual Stop Loss
Karthik.Mohan@LibertyMutual.com
774-217-9549
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