Stop loss insurance

With costly healthcare claims becoming more frequent, stop loss coverage is vital to shield self-funded employers from large medical and pharmacy claims in any given year.

How stop loss coverage protects you

  • Comprehensive coverage terms
    Negotiated terms including multi-year rate caps and limitations on “lasering” of high-risk claimants year to year by carriers means you have protection beyond just the current policy period.
  • Holistic review
    We take a consultative approach when placing coverage for you. We will review your existing insurance coverage and work to identify gaps in coverage or non-competitive terms and conditions. Then we can help find appropriate coverage through carrier partners to optimize your premium spend and insurance coverage.
  • Clinical and operational performance assessments
    Through necessary due diligence, we can evaluate vendor partner performance and manage high-cost claim irregularities. Our regular third-party assessments provide a foundation for continuous process improvement toward better clinical and financial results.
  • Care management services
    Solutions like Mercer Health Advantage™ deliver high-intensity care management for employees who have serious or chronic conditions and acute health needs. Our holistic approach can improve quality of care and health outcomes, while saving employers $430 annually per employee on average.

Make your stop loss coverage work for you

What if your stop loss coverage actively worked to reduce the risk of high-cost claimants? At Mercer, we’ve been developing new innovations around risk management. Click below to learn more about our latest innovation! (play time < 1 min)

Why choose Mercer for stop loss insurance?

We place more stop loss coverage than any other firm in the U.S. -- rely on our experience and trust to bring you the best policy options.  Our tenured clinicians assess more than 90 companies each year. Medical professionals in a range of clinical specialties coordinate with financial & audit experts to help deliver appropriate care.

Mercer has national agreements in place with a number of national stop loss carriers which provide Mercer clients with beneficial contractual and underwriting provisions.

Our dedicated internal stop loss team centralizes coverage planning. With our unparalleled expertise in the stop loss market, we provide the industry’s most comprehensive and competitive risk management arrangements.

Whether adding stop loss to an existing captive or pooling risk among multiple entities, Mercer’s Center of Excellence has the actuarial and captive experience necessary to support you in the process.
Related insights