Some people are suggesting that the states wanted to make it a little more painful for small employers to self-fund so that they'll have an incentive to go to the SHOP exchanges as opposed to purchasing stop-loss insurance
was self-insured with a health plan management company overseeing its stop-loss insurance
SIIA has long maintained that stop-loss insurance
is not health insurance and any attempts by states to regulate it as such would affect the administration of self-insured group health plans and would be lawfully preempted by ERISA.
The biggest boon to stop-loss insurance
in recent years may also pose its greatest threat.
Medical stop-loss insurance
covers claims above a certain cost for companies and organisations that fund their own employee-insurance plans.
James, whose company sells stop-loss insurance
, agrees that these disputes happen.
Companies that self-insure often purchase stop-loss insurance
to protect against large claims in the aggregate or on a per claimant basis.
SIIA) today announced the release of a new white paper, Self-Insured Group Health Plans, Stop-Loss Insurance
& Adverse Selection, which has been published to correct inaccurate information that state and federal policy-makers have been provided about how the self-insurance marketplace operates.
Within the last year, however, the world of self-funded benefits and stop-loss insurance
has begun to change.
However, today we face the greatest threat to self-insurance as states attempt to treat stop-loss insurance
(a critical component for most employers to be able to self-insure) as health insurance in making assessments to shore up their failed high-risk health pools.
closed formulary (the list of drugs that can be prescribed) and fiduciary functions such as stop-loss insurance
The health plan that capitates providers needs to maintain stop-loss insurance
and have in its contract with providers specific details of the level of costs for any individual patient and of the aggregate costs of all patients over which costs will no longer be charged against the risk pool.