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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.

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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.

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