Employer Stop Loss
Stop Loss insurance protects employers against expensive conditions such as cancer, organ transplants or other unexpected increases in overall health care use.
Minimize risk
Optum® Stop Loss insurance minimizes risk with a policy that aligns with the plan document. It also provides:
- Advanced funding through the 365th day of the policy year
- A 12/15 incurred policy with no gaps in coverage as long as the group renews their stop loss coverage with Optum
Ease of administration
Optum delivers prompt and efficient turnaround on claims reimbursement, including:
- A dedicated claims examiner and clinical resource
- Flexibility on lock-in dates
- A dedicated stop loss account manager assigned to service each stop loss account
Stop Loss is easy to sell and easy to buy
Whether companies employ 50 employees or 10,000, they have the flexibility to determine the amount of coverage they need and the amount of risk they’re willing to take. Employers may choose from different policy options and a wide range of deductibles.
Experience Reward option
Our unique Experience Reward option provides a premium refund up to 15% of net specific Stop Loss premium for groups with excellent claims experience. Groups must renew Stop Loss coverage with Optum to be eligible to receive the Experience Reward payment.
Related resources
Stop Loss checklist for ASO-administered groups
Use our Stop Loss checklist for ASO-administered groups to see how your current stop loss policy compares to Optum.
Stop Loss checklist for TPA-administered groups
Use our Stop Loss checklist for TPA-administered groups to see how your current stop loss policy compares to Optum.
Read: Stop Loss managed transplant program
Learn more about how combined Optum Stop Loss coverage with the Managed Transplant Program eliminates gaps in coverage.
Health savings accounts (HSAs) are offered or administered by Optum Bank®, Member FDIC, or ConnectYourCare, LLC, each a subsidiary of Optum Financial. HSAs are subject to eligibility requirements and restrictions on deposits and withdrawals to avoid IRS penalties. State taxes may apply. Fees may reduce earnings on account. Flexible spending accounts/arrangements (FSAs), health reimbursement arrangements (HRAs), Commuter and Parking Benefits, Adoption Reimbursement Plans, Tuitions Reimbursement Plans, Surrogacy Reimbursement Plans, Lifestyle Plans, COBRA Benefits, and all other account types are administered on behalf of your plan sponsor by Optum Financial, Inc. or ConnectYourCare, LLC (collectively, “Optum Financial”) and are subject to eligibility and restrictions. Please contact a legal or tax professional for advice on eligibility, tax treatment, and restrictions. Please contact your plan administrator with questions about enrollment or plan restrictions. Federal and state laws and regulations and the design of your plan are subject to change.
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