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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 ...
“If Dignity Health and Aetna do not agree to new contractual rates and terms before April 1, 2024, then Aetna will no longer include Dignity Health hospitals, physicians, ambulatory surgery ...
Aetna Inc. (/ ˈ ɛ t n ə / ET-nə) is an American managed health care company that sells traditional and consumer directed health care insurance and related services, such as medical, pharmaceutical, dental, behavioral health, long-term care, and disability plans, primarily through employer-paid (fully or partly) insurance and benefit programs, and through Medicare.
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 ...
NewYork-Presybterian, Aetna are locked in a contract dispute that could leave Hudson Valley patients with higher out-of-network costs. What to know. NewYork-Presbyterian, Aetna dispute may leave ...
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