At the same time, reserves shouldn't be greater than the amount that would be covered by aggregate stop-loss insurance
. In practice, this can be a complicated calculation, and many governments use a dollar amount that's equal to two or three months' worth of claims as a rule of thumb (in addition to the amount required for IBNR).
The opponents cite North Carolina as an example of a state that's tried to prevent what it sees as stop-loss abuse by regulating small stop-loss insurance
plans as if they were ordinary health insurance plans.
This model must consider the risk associated with self-insurance as well as the opportunity to mitigate that risk by purchasing stop-loss insurance
. To fully assess this choice, the model must include the different stop-loss alternatives available to the firm, the pricing of stop-loss coverage, and the effect of these policies on risk.
"Specific" stop-loss insurance
. Specific stop-loss insurance
protects against a catastrophic loss incurred by any individual covered by the plan, with the deductible set at a level appropriate for the size and financial strength of the company.
The administrator works with group insurance brokers and insurance firms to obtain quotes and find the appropriate stop-loss insurance
plan that fits the employer's needs.
Sun Life Insurance and Annuity Company of New York offers medical stop-loss insurance
for New York state employers with self-funded medical plans.
Survey results also feature utilization statistics, including average bed days and admits per 1,000 members; statistics on stop-loss insurance
premium amounts, attachment points and providers' purchase habits; capitation revenue and profitability trends; and contract characteristics.
Cairnstone Re managed employer stop-loss insurance
and provided catastrophic claims management assistance to more than 450 self-funded employer groups covering 300,000 lives in the US.
A must for all self-insurers: a stop-loss insurance
provider as umbrella coverage.
The law firm's health plan involved stop-loss insurance
and required after-tax contributions by employees.
Medical groups may also decrease their risk by reducing their revenues, increasing the use of subcapitation agreements or purchasing of stop-loss insurance
We've also dropped the cost of aggregate stop-loss insurance
. This is relevant to those companies that self-fund.