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:

 

  • Comprehensive coverage terms: Negotiated terms including multi-year rate caps and limitations on “lasering” of high-risk claimants year to year by carriers means you have protection beyond just the current policy period.
  • Holistic review: We take a consultative approach when placing coverage for you. 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 through carrier partners to optimize your premium spend and insurance coverage.
  • Clinical and operational performance assessments: Through necessary due diligence, we can evaluate vendor partner performance and manage high-cost claim irregularities. Our 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


+100%


 

Between 2016 and 2019, individuals with annual claims above $3.0 million doubled2

 



$3.30


 

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

 



Solutions

 

Well-Being
Our total health management solutions prioritize workers’ well-being for productivity and business performance. Get more by working with Mercer today.
Mercer Health Advantage™
Our smart benefits can contain employer costs with focused care management for workers who have serious health needs. Explore these solutions from Mercer.
Pharmacy Management
Strategic pharmacy solutions may help employers control drug costs while helping employees tackle healthcare challenges. See how Mercer can help.
Solutions for Large Enterprises
Innovative strategies and solutions help large employers empower, retain and attract talent and transform healthcare. Explore your options by visiting Mercer today.

Why choose Mercer for stop-loss insurance?

 

Managing high-cost claims is risky business with far-reaching financial ramifications. Your organization needs serious expertise to help manage healthcare expenses and avoid unnecessary costs. Mercer can assist you with:

 

Experience

 

We place more stop-loss coverage than any other firm in the U.S. -- rely on our experience and trust to bring you the best policy options.  Our tenured clinicians assess more than 90 companies each year. Medical professionals in a range of clinical specialties coordinate with financial & audit experts to help deliver appropriate care.

Industry-leading national agreements

 

Our Stop-Loss Coalition leads the industry. Our profit-sharing provisions have resulted in more than $23 million in premiums 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.

Captive alternatives for financing stop-loss related risk

 

Whether adding stop loss to an existing captive or pooling risk among multiple entities, Mercer’s Center of Excellence has the actuarial and captive experience necessary to support you in the process.

 

 Mercer’s National Survey of Employer-Sponsored Health Plans

 

 2018 Sun Life Stop-Loss Research Report

 

 Results may vary

 

Contact us

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

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