Search results
Results from the WOW.Com Content Network
Insurance companies themselves, as well as self-insuring employers, purchase stop-loss coverage for a premium to protect themselves. In the case of a participant reaching more than the specific (or "individual") stop-loss deductible ($300,000, for example), the insurer will reimburse the insured (the company, not the participant) for the remainder of the claim to be paid over that deductible ...
Stop-loss insurance reimbursements are made if the claims costs exceed the catastrophic claims levels in the policy, but if a stop-loss carrier became defunct or simply breached the contract, there would be nothing alleviating the self-funded plan from responsibility for the full amount of claims.
Stop-loss was created by the United States Congress after the Vietnam War. Its use is founded on Title 10, United States Code, Section 12305(a) which states in part: "... the President may suspend any provision of law relating to promotion, retirement, or separation applicable to any member of the armed forces who the President determines is essential to the national security of the United ...
A leading stop-loss insurance carrier announces SunElite, SM a medical plan document review service to help self-insured employers comply with the Affordable Care Act and manage cost containment
Like COBRA enrollment, you have 60 days after losing your job and health coverage to take advantage of the special enrollment period afforded to you by an Affordable Care Act (ACA) plan. These ...
Stop-loss insurance provides protection against catastrophic or unpredictable losses. It is purchased by organizations who do not want to assume 100% of the liability for losses arising from the plans. Under a stop-loss policy, the insurance company becomes liable for losses that exceed certain limits called deductibles.
Firms are often "self-insured", meaning they reimburse the insurance companies that pay the medical claims on behalf of their employees. Employers may use a stop-loss, meaning they pay the insurance company a premium to cover very expensive individual claims (e.g., the firm is self-insured up to a threshold for individual workers).
Depending on the company and coverage plan, some medications, like Wegovy, are now covered for weight loss, but for people on Medicare, a 2003 law actually prevents weight loss medication coverage.