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 premiums.
“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 reimbursements.