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The stop-loss policy runs solely between the employer and the stop-loss carrier and creates no direct liability to those individuals covered under the plan. This feature provides the critical distinction between fully insured plans (subject to state law insurance regulations) and self-funded health plans, which, under the provisions of Section ...
Insurance companies themselves, as well as self-insuring employers, purchase stop-loss coverage for a premium to protect themselves. [1] 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 ...
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 ...
Hackensack Meridian Health, locked in a contract dispute with Aetna, has sent letters to the insurer's customers warning them that they may lose in-network coverage if the two sides can't reach a ...
Mark Bertolini, former Aetna CEO and current chief executive of Oscar Health, said Americans’ frustration with insurance systems is justified.Employer-sponsored health insurance, which insured ...
Aetna has agreed to settle a lawsuit that accused the health insurer of discriminating against LGBTQ+ customers in need of fertility treatment. Under the deal announced Friday, the insurer will ...
Stop-loss may refer to: Stop-loss insurance, an insurance policy that goes into effect after a set amount is paid in claims; Stop-loss order, stock or commodity market order to close a position if/when losses reach a threshold; Stop-loss policy, US military requirement for soldiers to remain in service beyond their normal discharge date
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.