Stop loss

Stop-Loss coverage

With stop-loss coverage, employers with self-funded healthcare plans can proactively manage their unexpected medical claim risks while minimizing financial liability. Humana is proud to offer both specific stop-loss and aggregate stop-loss, along with aggregating specific as an optional benefit.

How can stop-loss insurance help your clients?

High utilization and claims costs can have a negative effect on a company's health plan. Stop-loss insurance permits clients to choose the amount of risk they're comfortable with.

The benefits include:

  • Cost liability reduction
  • Cash flow protection
  • Buffer against rising healthcare costs
  • Long-term cost control
  • Access to discounted specialty care management programs

Product details

  • Designed to protect against large medical claims from any one employee by providing coverage for liabilities above a specific dollar amount set by the employer
  • The stop-loss policy will specify when the expenses must be incurred and paid to be eligible for reimbursement
  • No additional laser required at renewal
  • Disclosure on new cases only
  • Specific advance — assures prompt reimbursement by payer (claim minimum is $1,000)

Flexibility to meet each employer's unique needs

  • $35,000 minimum deductible
  • Variable lifetime maximums
  • Deductible Rewards program uses reduced deductibles and fees to encourage use of Centers of Excellence and medical management services
  • Broad range of contract types
  • Customized reimbursement structures, such as tiered reimbursements
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