Stop-Loss Insurance

Stop-Loss Insurance | Health & Benefits | Mercer

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With high-cost claims on the rise, 74% of self-funded employers protect themselves with stop-loss coverage.¹ What’s equally vital to an effective health and benefits program? Care guidance to help employers use benefits most productively. We offer both.

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87%

increase in frequency of health claims above $1 million from 2014 to 2017²
$3.30

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

Why Choose Mercer for Stop-Loss Insurance?

High-cost claims are serious business. Your organization needs serious expertise to help manage and avoid unnecessary healthcare expenses. Mercer can assist you with:

Experience

We place more stop-loss coverage than any other firm in the U.S. That means you can rely on our experience and trust that we’re bringing you the best policy options.

Industry-Leading National Agreements

Our Stop-Loss Coalition leads the industry. Our profit-sharing provisions have resulted in more than $19 million in premiums being refunded to clients since 2009.

Center of Excellence Approach

Our dedicated internal stop-loss team centralizes coverage planning. With our unparalleled expertise in the stop-loss market, we provide the industry’s most comprehensive and competitive risk management arrangements.