of self-funded employers protect themselves with stop-loss coverage.1
increase in individuals with annual claims above $3M between 2019 and 2020.2
1 Mercer’s National Survey of Employer-Sponsored Health Plans
2 2020 Sun Life Stop-Loss Research Report
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.
Mercer, in partnership with pharmacy and medical clinicians, will use your pharmacy and medical claims data to provide better and more cost-efficient solutions.
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.
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
Learn how a corporation service company with 1,500 covered lives saved over $1.2M after we negotiated new contract terms with their provider.
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.
Mercer has national agreements in place with a number of national stop loss carriers which provide Mercer clients with beneficial contractual and underwriting provisions
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.
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.
Find out how Mercer’s care and claims management solutions can keep your employee health and benefits program moving forward.
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