Stop Loss provides protection against
catastrophic or unpredictable claims and aims to moderate the financial risks employers
face when self-funding a medical plan. Guardian’s new product has been approved
in 23 states; nationwide approval is expected by mid-2014. Stop Loss puts a
limit on the total financial risk employers can face, thereby reducing the
uncertainty and potential liability of a self-funding medical plan.
In 2011, six in 10 (60%) U.S.
employees who were covered by employer-sponsored health insurance were in firms
that self-insure, according to a study by the Kaiser Family Foundation.
Self-funded medical plans are traditionally a funding option favored by large
employers, but midsized and small firms may find this model attractive, as
well. Self-funded plans may lead to lower costs, improved cash flow and reduced
“As employers seek ways to
control costs, shifting to a self-funded health plan is something they may
consider,” said Ray Marra, vice president of group products at Guardian. “Guardian’s
Stop Loss insurance enables employers—large or small—that self-fund to manage
plan costs while still delivering the health coverage their employees require.”
Guardian’s insurance has no
minimum threshold before reimbursements are paid and can coordinate with an
employer’s medical carrier or third-party administrator (TPA) for timely claims