increase in frequency of health claims above $1 million from 2014 to 2017²


Average return on every dollar spent by Mercer’s care management solution clients³

How stop-loss coverage protects you

With costly healthcare claims becoming more frequent, stop-loss coverage is vital to shield self-funded employers from large medical and pharmacy claims in any given year. Our comprehensive approach can help you with the right care and claims management strategy:    



  • High-cost claims oversight: Negotiated terms and conditions to limit the “lasering” of high-risk claimants year to year by carriers. That means you have more protection when it comes to renewal rates and high-cost claims.
  • Claims audit: In addition to placing coverage, we take a consultative approach. We will review your existing insurance coverage and work to identify gaps in coverage or non-competitive terms and conditions. Then we can help find appropriate coverage levels and ways to maximize your benefits and coverage.
  • Clinical and operational performance assessments: Necessary due diligence can evaluate vendor partner performance and manage high-cost claim irregularities. Regular third-party assessments provide a foundation for continuous process improvement toward better clinical and financial results.
  • Care management services: Solutions like Mercer Health Advantage™ deliver high-intensity care management for employees who have serious or chronic conditions and acute health needs. Our holistic approach can improve quality of care and health outcomes, while saving employers $430 annually per employee on average.³


          1  Mercer’s National Survey of Employer-Sponsored Health Plans


          2  2018 Sun Life Stop-Loss Research Report


          3  Results may vary


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Find out how Mercer’s care and claims management solutions can keep your employee health and benefits program moving forward.

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