What is Stop Loss Insurance?


Removing the risk with Stop Loss Insurance

Any risk of claims exceeding the amount set aside in the healthcare fund can be capped by taking out Aggregate Stop Loss insurance. This will pay for any claims exceeding a specified amount, typically set at around 115% – 125% of the fund value for many Healthcare Trusts in the market.

We can arrange Stop Loss Insurance at Lloyds of London on your behalf and this can be set at a level to suit you so if claims should exceed that amount, the Stop Loss insurance will kick in and cover any further claims.

100% Aggregate Stop Loss

We have a unique arrangement allowing us to provide Aggregate Stop Loss insurance at 100% of the anticipated claims fund on our Healix100 Healthcare Funds. This means that employers can rest assured that their claims’ costs are guaranteed not to exceed the value of their fund, eliminating any ‘risk’.

Single Claim Protection

The whole of the healthcare market has seen a significant uplift in cancer claim costs in recent years.  The average cost of a cancer claim three years ago was £50k, but now insurers are regularly seeing cancer claims breaching £100k, £200k and £300k.

As such these claims can seriously affect the long term sustainability of the healthcare scheme. Healix has developed an array of options to help protect clients’ funds against the impact of individual High Cost Claims. These include a traditional Specific Stop Loss insurance which will reimburse the claims fund for the cost of any claim above an agreed limit and a Single Claim Retention Limit arrangement which caps the impact that a high claim will have on the claims fund going forward.

Our Stop Loss insurance arrangements ensure that our clients’ healthcare trust funds are not only protected from total claims exceeding the estimated claims fund but also from any individual high cost claims making a big dent in the fund. Furthermore, with the claims fund being less susceptible to spikes from high cost claims, the estimated claims fund will be stabilised for future years.

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