Medical Stop Loss
Self funding continues to be a viable, cost effective option for employers of all sizes. As confirmed by recent DOL and HHS studies required under health care reform legislation, stop loss insurance can be vital to the overall risk management of a self funded employee medical benefit program. Medical Stop Loss is designed to protect the financial risk of the plan. It is not health insurance.
At StarLine, we design Medical Stop Loss programs that keep up with the times. Let our distribution partners show you how to design a program with the flexibility you need and the financial security you demand.
- Distribution
- Coverage Highlights
- Specific Stop Loss
- Aggregate Stop Loss
- Medical Management Advantage
Our Distribution Philosophy
Expertise and a commitment to the self funded industry is what we require from our distribution and administration partners. By offering traditional stop loss products through limited distribution partners, we aim to customize programs that will foster long term solutions. At StarLine we are focused on creating stop loss solutions for niche markets by striving to find ways to be different, listening to our partners and acting in accordance with their needs.
Our Distribution Partners
Managed Care Stop Loss – We work directly with managed care organizations (MCOs) to provide stop loss solutions for their self funded programs. By taking the time to understand the strength of their proprietary provider networks and integrated services, we are able to determine the value and apply the appropriate pricing credit to the stop loss rating. Either as a reinsurer supporting an insurance company or as an outsourced provider of stop loss, each relationship is unique. Our expertise in both medical reinsurance and stop loss provide us with the flexibility to provide customized solutions where others cannot. Contact us directly to discuss how we can assist with your managed care stop loss program.
Traditional Stop Loss – We are better able to serve our customers and continue to focus on our strengths within the stop loss market by offering traditional stop loss products through a few key select distribution partners. Our business model is designed to provide you with improved service and streamlined results. Our distributors have a high level of experience with StarLine and stop loss that is necessary to service your business. We encourage you to contact one of our partners for your StarLine and other stop loss needs.
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Benefit Dynamics Company |
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One Source StopLoss Insurance Marketing |
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Stop Loss Insurance Services |
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Outsource Marketing Strategies, Inc. |
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XS Insurance, Inc.
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- A “10 or better” service commitment - 10 day quote turn around, 10 day policy issue, 10 day clean claims payments, firm rates with 10 months experience
- Direct access to underwriters
- Competitive rates, comprehensive terms and fair renewals
- No disclosure statements required on renewals
- Creative solutions to known claims
- Managed care expertise determines our discounts for managed care networks and programs
- A unique shared savings opportunity is available by accessing StarLine’s Medical Management programs - 20% of the savings are passed directly back to the employer
- Automatic claims payment via electronic funds (optional)
- Specific claim advancement included
- Streamlined claims submission process
Specific coverage protects an employer against covered claims by an individual in excess of a pre-determined amount, or a specific deductible. It is not health insurance and it is written as a reimbursement policy.
- Offered on a stand alone basis or with aggregate coverage
- Minimum deductible of $50,000 preferred for traditional stop loss coverage
- Minimum deductible of $20,000 preferred for MCO stop loss coverage
- Desired group size over 100 lives
- A variety of coverage maximums available, up to unlimited
In conjunction with Specific Stop Loss coverage, Aggregate coverage protects an employer against an unforeseen fluctuation or increase in accumulated group claims during the contract period.
- Provides reimbursement to plan sponsor when claims exceed a set amount
- Coverage maximums available up to $2,000,000
Claims Savings & Expert Consultation
We are pleased to offer our clients an innovative solution that combines clinical and claim management consultative services into one program. It’s called StarLine Medical Management Advantage. Our medical management and claims staff are experts in catastrophic claim management and know how to untangle the web of treatment possibilities and medical jargon. They will help explore options for alternative plans of care and will work with the client’s case managers to assure the best possible clinical and financial outcomes.
Should you need help with complex claim situations, Medical Management Advantage offers you the minds and ears of some of the finest professionals in their specialty area. They will help you identify solutions and guide you toward making informed decisions. The following specialists are included in the Medical Management Advantage program: transplants, dialysis cost containment, cancer management, neonatal management, case management, claim negotiations and re-pricing, healthcare fraud and abuse detection and subrogation.