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Employer Stop Loss

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Stop Loss insurance protects employers against expensive conditions such as cancer, organ transplants or other unexpected increases in overall health care use.

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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.

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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.

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Related resources

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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.

Download PDF

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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.

Download PDF

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Read: Stop Loss Experience Reward

Learn more about reward options and how they work.

Download PDF

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Read: Stop Loss managed transplant program

Learn more about how combined Optum Stop Loss coverage with the Managed Transplant Program eliminates gaps in coverage.

Download PDF

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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.

Self-directed mutual fund investment options are made available through the services of an independent investment advisor, or your plan sponsor. Discretionary advisory services are provided by Betterment LLC, an SEC-registered investment adviser, with associated brokerage transactions provided by Betterment Securities, member FINRA/SIPC. For details and disclosures visit betterment.com. Certain brokerage services are offered through TD Ameritrade, Inc., member FDIC/SIPC and a subsidiary of The Charles Schwab Corporation.  For details and disclosures, visit  www.tdameritrade.com. The Schwab Health Savings Brokerage Account is offered through Charles Schwab & Co., Inc., member FINRA/SIPC. For details and disclosures, visit schwab.com.

Orders are accepted to effect transactions in securities only as an accommodation to HSA owners. Optum Financial and its subsidiaries are not broker-dealers or registered investment advisors and do not provide investment advice or research concerning securities, make recommendations concerning securities, or otherwise solicit securities transactions.

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