What are the benefits of self-funding? 
A self-funded plan gives employers more control and may lead to significant savings and cash-flow benefits. Employers don’t have to pay monthly premiums for the care employees and their dependents receive, nor do they have to adhere to state mandates that require minimum coverage for treatments like chiropractic and mental health care. A self-funded plan also gives employers the freedom to change coverage as needed and eliminates premium taxes in most states.
Who is insured under a medical stop loss policy?
Medical stop loss insures the employer. Or more accurately, it insurers the employer’s plan against large or catastrophic claims.
What coverages are available under a medical stop loss policy?
Stop loss offers Specific (also known as Individual) and Aggregate coverage.
Specific stop loss protects an employer against abnormally high claims made by a particular individual covered under the plan. This could be an employee or a dependent. Specific stop loss claims are paid throughout the policy period whenever the deductible is met.
Aggregate stop loss caps the total amount of claims an employer pays during the policy period (generally one calendar year) for the entire group. The stop loss carrier reimburses the employer at the end of the policy period.
What is a plan document?
The plan document describes the benefits provided by the health plan. It tells a group’s third party administrator (TPA) how to pay claims and gives the stop loss provider the tools needed to validate claims.
