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Self-Funded | Stop-Loss

Help your self-funded clients find the right stop-loss solution.

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Superior Products & Service

Specializing in stop-loss insurance, BenefitMall provides your clients with superior coverage at competitive rates. Our dedicated staff reduces risk to clients, brokers and consultants.

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Services

BenefitMall is a leader in the alternative-funded marketplace. We stay current on products and legislation – and we have valuable, established relationships with major Carriers in the Self-Funded market. As a partner, we are happy to provide the following comprehensive services including:

Marketing

Compare stop loss rates and provide a detailed spreadsheet of Carrier products and consultative services.

Billing and Premium Collection

Offer billing and premium collection, reconciliation, and remittance.

Licensing and Commissions

Ensure the proper licensing requirements are met and pay commissions within 48 hours of receiving the premium payment.

Claims Expedition

Collect claims data and track ongoing claims.

Compliance Services

Answer regulations questions. We can also conduct compliance reviews of plan documents and stop loss policies.

Ancillary Services

Products for Life, Disability, Dental, and Vision.

Benefits of Self-Funded Insurance

Our Self Funded Division includes experts in the alternative-funded marketplace. BenefitMall provides you and your clients with superior ancillary benefit plans at the most competitive rates. Highlighted in this brochure are two recent case studies and an overview of the products we offer.

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Lower Costs

By directly financing claims, an employer evades paying claim reserves, Carrier administrative profit margin, risk charges and premium taxes which are all costs that go into a monthly premium.

Cost Management

Flexibility and analysis allows employers to make plan changes necessary to managing costs. A Third Party Administrator (TPA) can supply employers with the tools and data needed to make necessary decisions to design a plan that allows for easier management of costs.

Stronger Flexibility

Self-funded health plans are exempt from state insurance laws that usually mandate certain benefits for other plans. They also allow employers to build a health plan to target specific employee needs and company goals.

Healthcare Reform Loopholes

Self-funded insurance plans are exempt from many ACA requirements

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Types of Coverage

The amount of risk for self-funding can be limited through the use of stop-loss insurance. A stop-loss insurance policy is one of the most important components of a self-funded plan. It's important to understand the different types of coverage available to employers.

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Individual (Specific)

Specific coverage protects against catastrophic claims acquired by a specific individual.

Group (Aggregate)

Aggregate coverage protects against combined collected claim activity for the plan that is expected to exceed a maximum limit.

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Limit your risk on self-funded plans

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  • What is Stop Loss insurance?

    Stop Loss is a tool used in self-funded insurance plans to reduce the overall liability of claims. In a self-funded plan, the employer takes on the financial risk of providing health care benefits to employees instead of the insurance company. The employer is then responsible for all employee and plan member claim costs by all employee and plan members. The employer's plan is usually executed by a Third Party Administrator (TPA) who manages medical claims, establishes a provider network and more. The employer can utilize numerous tools, including Stop Loss insurance, to help manage total losses by improving their ability to lower plan premiums and costs.

  • How does Stop Loss insurance help my client?

    The ability to provide competitive Stop Loss insurance is very important in determining your client's ability to self-fund. Since your client is taking on the financial risk of covering all medical claims, their main concerns may include; individuals with catastrophic claims and their employee's overall use of the health plan. 

    Stop Loss insurance is built to cover catastrophic claims that exceed your client's per-determined risk tolerance. Stop Loss insurance is available in Individual (Specific), which covers catastrophic losses on each individual insured under the health plan, and Group (Aggregate), which provides additional protection for self-funded health plans designed to limit the plan's maximum financial risk.

  • Should my client consider self-funding?

    Not every employer is right for self-funded insurance. A common misunderstanding is that self-funding is only for large employers. Self-funded insurance plans can be set up by smaller employers as well. There are no rules to follow to determine if your client is right for a self-funded plan. The best way to determine if your client can benefit from self-funding is to analyze their existing health plan and recent claims.

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Our Products

We'll help you get the right mix of products that is both complete and compliant

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