Blog Article
"Lasering" vs. Premium Adjustments: Here’s What Employers Should Know About These Risk-Shifting Tactics
Stop Loss Insurance
Stop Loss Insurance Coverage & Consulting
As healthcare costs climb and large claims become more common, employers need a safety net. OneDigital’s stop loss insurance solutions give self‑funded organizations the coverage, control and confidence to manage risk, without compromising care.
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Stop Loss Consulting
Strategic Coverage, Tailored to Your Risks
Our Stop Loss Center of Excellence provides strategic guidance, carrier marketing support, and risk modeling. We help self-funded employers evaluate exposure, optimize pricing, and build a sustainable coverage roadmap.
Stop Loss Insurance FAQs
Answers to the common questions employers ask about stop loss coverage and how it supports self‑funded health plans.
Stop loss insurance should not be viewed simply as a commodity. While it may appear interchangeable at first glance, policy terms, contract details, claims support, financial stability, and carrier responsiveness can meaningfully impact risk protection and long-term costs. Choosing stop loss based on price alone overlooks critical differences that can affect an employer’s financial security and the overall effectiveness of a self-funded health plan.
Whether you should accept a laser on your stop loss policy depends on your organization’s risk tolerance, cash reserves, and claims history. Accepting a laser, which assigns a higher deductible to a high-risk individual, can lower premiums but shifts the potential cost of large claims back to your plan. If you can absorb an unexpected claim or expect that high-cost conditions will not recur, taking a laser may make financial sense. However, if budget predictability and stronger risk protection matter more, paying for a no-laser option may be the better choice. It’s best to review your group’s health profile with an experienced consultant before making a decision.
To determine the right stop loss carrier for your self-funded plan, evaluate key factors such as contract terms and flexibility, claims administration and responsiveness, pricing and renewal patterns, and the carrier’s experience with groups similar to yours. Work with a knowledgeable consultant to compare quotes, review sample contracts, and assess each carrier’s willingness to explain terms and resolve issues. Avoid choosing based on price alone; select a partner whose contract structure, service model, and financial stability align with your risk tolerance and long-term goals.
Yes, you can choose your deductible level for stop loss coverage. Employers can select from a range of deductible options. Lower deductibles offer greater protection but come with higher premiums, while higher deductibles reduce premium costs but increase the amount you must pay before reimbursement begins. This flexibility allows you to align your deductible with your risk tolerance, cash reserves, and claims history. Your broker or carrier can walk you through multiple scenarios to help determine the best fit for your organization.
OneDigital supports stop loss by providing specialized expertise, dedicated claims and service teams, and access to top-rated carriers for self-funded employers. Our consultants help evaluate deductible options, negotiate competitive contracts, and secure favorable terms, while also managing administrative details and supporting accurate claims reimbursement and helping navigate carrier processes. This end-to-end support helps employers reduce financial exposure, strengthen risk protection, and maintain confidence in their health plan strategy.
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