Many commissioners were originally pushing for an update to the NAIC stop-loss model act to include "aggressive new restrictions for stop-loss insurance
," Ferguson said, noting the effort failed to secure the needed support.
There's a lot of debate about how to define an insured plan versus a self-insured plan, and one of the factors is shifting the risk and at what point the stop-loss insurance
starts paying claims.
Over the past year, federal regulators from the IRS, HHS and DOL have all expressed concerns that smaller employers rely on stop-loss insurance
with “low” attachment points to self-insure in order to escape various state and federal regulatory requirements.
offers two different coverage types.
Our members who face the prospect of state assessments on stop-loss insurance
can take heart from this summer's ruling by the Minnesota Supreme Court that denied state collection of premium-based assessments.
But in the last few years, reinsurance companies made self-funding practical for thousands of small companies by offering stop-loss insurance
at levels appropriate for smaller firms.
Inquire among the better stop-loss insurance
carriers and agents about the reputations of any TPAs they deal with.
The video, "Self-Insurance 101: A Practical Guide," which provides background on self-insurance trends and medical stop-loss insurance
, is also available on www.
mitigates risk by insuring the self-funded employer against unexpected increases in overall plan utilization or the impact of a single catastrophic claim.
Another benefit is that group members can self-insure their health insurance plans, then form the RRG to provide excess coverage for their health plans--in effect replacing stop-loss insurance
Lincoln Re Risk Management Services is expanding its Special Alternatives program of claims management tools for the employer stop-loss insurance
market to include comprehensive case management services from Des Moines, Iowa-based Encompass Health Management Systems and transplant access through InterLink Health Service Inc.
Under self-funding, you generally buy stop-loss insurance
to protect yourself against the very big claim," Cuppett explains.