MEDICAL STOP LOSS

EBU’s innovative underwriting solutions have become a familiar trademark of the professionals at Employer Benefit Underwriters, Inc. Through proper risk analysis and flexible underwriting authority, EBU will assist you in exceeding your clients’ expectations. As a Managing General Underwriter for leading reinsurance intermediaries, EBU is uniquely structured to offer product alternatives and carrier security which are critical in today’s marketplace.

Underwriting Options

EBU, Inc., is pleased to be able to provide you quotes for Medical Stop-Loss. Whether your client is currently Self-Funding or transitioning from Fully-Insured to Self-Funding, we have options to serve you. Each group is unique, should your groups fall outside the parameters of our guidelines, it would be our pleasure to see if we can obtain carrier approval to serve your needs.

Specific Stop Loss

Specific Stop Loss provides financial protection for self-insured employers from large claims that occur for any one covered individual.

Aggregate Stop Loss

Aggregate Stop Loss provides financial protection when medical claims exceed what an employer expected for the entire group.

Available Options

Aggregating Specific Deductible, Specific Advance Funding, Monthly Aggregate Accommodation, No New Laser on Renewal, Specific and Aggregate Terminal Liability, Reference Based Pricing, Contract Basis: 12/12, 12/15, 12/18, 18/12, 24/12*

*24/12 offered for incumbent TPA only

Underwriting Options	Carrier Options
Minimum Group Size *subject to required state minimum	26 employees
Minimum Specific Deductible	$20K
States Available	All States
Aggregating Specific Deductible (option available)	Yes
Specific Advance Funding (option available)	Yes
Monthly Aggregate Accommodation (option available)	Yes
Aggregate Terminal Liability (option available)	Yes
Minimum % Participation	70%
Reference Based Pricing	Yes
Level Funded Option	No

Reference Based Pricing

Reference Based Pricing (RBP) is the art of replacing PPO networks with reimbursements tied to a percentage plus of Medicare allowable rates. This model is an option for self-funded employers seeking to limit costs by providing a fixed amount for certain healthcare services, usually as a percentage of Medicare. By utilizing Reference Based Pricing to replace the primary PPO network for facility claims, plan sponsors may be able to substantially cut spending.

Reference Based Pricing

Illustrative Client Profile: self-funded, multi-state group with 220 employees
Annual Savings: 32% on Claims and 27% on Medical Stop Loss

Get In Touch

If you'd like to have our team contact you to get a better understanding of your needs, it would be our pleasure to personally assist you. Send us some quick information and we'll get back to you quickly with everything you need to get a quote. Or call us and speak to a live person during normal business hours at (386) 274-2600 x 0.