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Stop Loss Insurance

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Stop Loss Insurance for Healthcare Providers

Stop Loss insurance protects healthcare organizations from catastrophic claims that exceed predetermined levels. The stop loss policy will either pay the significant claim or reimburse the insured if the total value exceeds the limit.

Specifically, stop loss insurance provides P&L financial stability for unpredictable large claims, including:

NICU Claims
Transplants
Care for Chronic Cases (CHF, COPD, Diabetes)
Chemotherapy

HMO Re-Insurance

Provider Excess of Loss

Value Added Services Available from Insurance Carriers (prior negotiation required)

HMO Re-Insurance

Re-insurance products for entities such as HMOs, PPOs, and other Managed Care Organizations – licensed as insurers- retain some financial risk associated with providing medical services to a defined population. Applicable entities include:

Medicare Advantage Programs

Provider Excess of Loss

Insurance products for healthcare providers that have agreed to assume a portion of the financial risk associated with providing medical services to a defined population through either capitation or another form of “risk-based contracting.” Applicable entities include:

Hospitals
IPAs
PHOs
Medical Groups
ACOs / CCOs
PACE Programs

Value Added Services Available from Insurance Carriers (prior negotiation required)

Access to Transplant Networks
Case Management Services
Bill Audit / Review Services
Supplemental PPO Networks w/ Supplemental Contract Negotiations
Specialty Pharmacy Management & Network

Purchasing stop loss insurance is a risk management tool that helps protect healthcare organizations. Chivaroli & Associates will thoroughly review historical incidents and claims to develop recommendations for minimizing these risks for your organization.

Stop Loss Insurance