Provided by A&H Group

Medical Stop Loss

Protects employers with self-funded health plans against the risk of severe losses.

Best For:

  • Employers with self-funded health plans

Highlights:

  • Minimum group size of 50 lives or more
  • Discounts for quality PPOs, UR, large case management programs and quality plan documents
  • Flexible medical stop loss contract
  • Turnkey captive option available

Summary of Coverage

Medical stop loss insurance protects employers with self-funded health plans against the risk of severe losses.

Specific stop loss summary of coverage: Our specific stop loss coverage provides a protection against catastrophic claim above the specific deductibles. Specific deductibles available from $10,000 to $1,000,000*.

  • Standard maximum limit is $1,000,000; options of $2,000,000, $5,000,000, $10,000,000*
  • Full range of contract claims basis: 12/12, 12/15, 12/18, 12/24, 12/36, 14/12, 15/12, 18/12, 24/12, paid, incurred.

Aggregate stop loss summary of coverage:

Our aggregate stop loss coverage provides protection in the event the total paid losses exceed the expected claims plus corridor during the policy period. Flexible attachment points; 125% standard. Lower/higher available*.

  • Claims Basis: 12/12, 12/15, 12/18, 15/12, 24/12, paid
  • Standard Maximum limit: $1,000,000; options of $2,000,000, $5,000,000, $10,000,000*
  • Monthly or annual aggregate premium payment available

Optional features:

  • Specific split-funded premium arrangement
  • Simultaneous funding on specific reimbursements
  • Monthly aggregate advance reimbursement
  • Terminal aggregate liability coverage
  • Terminal specific liability benefit
  • Medical conversion available
  • Contract Advantage Plan (CAP)
  • Early lock down

Additional advantages:

  • Extensive technical and medical staff resources onsite
  • Claim repricing capabilities with access to several passive PPO repricing arrangements
  • Utilization review and case management oversight programs
  • Direct access to decision making personnel in administration, claims and underwriting

Documents & forms

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Resources

Management Group

Regional Contacts

Underwriting

A&H Claims

Policy Issuance

Premium Accounting

why choose tmhcc

Why choose Tokio Marine HCC?

With 4,400 employees worldwide, Tokio Marine HCC (TMHCC) underwrites more than 100 specialty insurance products across over 180 countries and territories, making it one of the world’s leading specialty insurers.

More about us Financial strength

Not all products, coverages, or features may be available in all states. Restrictions, exclusions, limitations, and conditions apply and you should see your agent for more information. Certain products and services are provided through non-admitted insurance carriers and are not subject to certain State Guaranty Funds.

HCC Life Insurance Company operating as Tokio Marine HCC - A&H Group