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Excess loss insurance

Excess Loss Insurance, or "Stop Loss Insurance" provides a backstop for self-insured plans. This insurance protects the self-insured plan from the impact of large catastrophic claims and much higher than anticipated total losses. The first of these protections is in the form of Specific Stop Loss and the second called Aggregate Stop Loss.

Specific Stop Loss
Specific Stop Loss insurance defines an amount over which the self-insured plan no longer has liability and the excess loss carrier takes over. Usually, this is between $50,000 - $125,000 for a single claimant in a year.

Aggregate Stop Loss
Aggregate Stop Loss insurance sets a limit in terms of an amount over the best estimate of what claims would be. Usually, this limit would be 120% of expected claims. So if a self-funded plan's claims are more than 20% higher than it had expected, then the excess loss carrier takes over liability for claims over this amount.




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