Services

Medical Stop Loss

Product Highlights

  • Minimum size group of 25 lives or more – can reconsider less
  • Discounts for quality PPOs, UR, Large Case Management programs and quality plan documents
  • Underwrite non-standard risks (Associations, PEOs, Schools, Municipalities, Native American organizations, Unions, Agribusiness)

Specific Stop Loss Summary of Coverage

Our Specific Stop Loss Coverage provides a protection against catastrophic claim above the specific deductibles. Specific deductibles available from $15,000 to $1,000,000.

  • Standard maximum limit: $1,250,000; options of $2,000,000 – $5,000,000, Unlimited
  • Contract claims bases: 12/12, 12/15, 12/18, w/ carrier approval -> 12/24, 15/12, 18/12, 24/12, Paid, Short or Long-Term contract are available with carrier approval

Aggregate Stop Loss Summary of Coverage

J. Allan Hall & Associates’ Aggregate Stop Loss coverage provides protection in the event the total paid losses exceed the expected claims plus corridor during the policy period. Our attachment points are 125% standard, although lower/higher is available.

  • Claims Bases: See Specific above
  • Standard Maximum limit: $1,000,000; options of $2,000,000
  • Monthly or annual aggregate premium payment available
  • Advanced funding available

Optional Features

  • Simultaneous funding on specific reimbursements
  • Monthly aggregate advance reimbursement
  • Terminal aggregate liability coverage
  • Medical conversion available
  • Aggregating specific options

Value-Added Services

  • Extensive technical and medical staff resources on-site
  • Underwriters with 25+ years each of experience
  • Claim re-pricing capabilities; access to several passive PPO re-pricing arrangements
  • Direct access to decision making personnel in administration, claims and underwriting

International

  • Fully insured and Self Funded
  • Medical tourism failed procedure coverage
  • Individual and group coverage
  • Medical, life, dental
  • Covers U.S. residents while overseas
  • Covers non-U.S. residents while in the U.S.
  • Covers non-U.S. residents in their own or other countries

Captives

Captive arrangements include:

  • Fronting
  • Reinsurance
  • Captive management
  • Administration
  • Employer owned, producer owned, and association owned
  • Medical products
  • Ancillary products