Stop loss
Capping your health plan risk
If you self-fund your employee health care plan, stop loss can help protect it against large and catastrophic claims.
When it comes to stop loss, First Symetra delivers flexibility and options most carriers can’t match
No new or increased lasers at renewal.1
No declined renewals due to poor claims experience.
Limited general exclusions.
Terminal liability options.
No exclusions or limitations that conflict with your plan document.
Prescription drug benefits.
Two coverage options
Choose one or both of the following—whichever meets your needs:
Specific
Provides large-claim and catastrophic coverage per individual plan participant.
- Deductibles starting at $25,000.
- Unlimited lifetime and annual benefits.
- Aggregating Specific option.
- Advance funding standard on all policies.
Aggregate
Provides coverage for the entire group to limit overall claim costs.
- Flexible corridors—125% is standard; others may be available.
- Maximums up to $10 million may be considered.
- Aggregate accommodation is available based on group size.
No surprises
Best-in-class policy
Our policy mirrors your plan document without any conflicting limitations or definitions.
Efficient claims processing
We pay claims quickly. And our low documentation requirements mean you won’t be burdened with extra paperwork.
Predictable reimbursements
Find out in advance how a claim will be reimbursed, through our technical referral assistance program.
Cost containment
Our specialist works with vendors and Centers of Excellence to negotiate the best possible price for expensive treatments that could affect the plan.
Next Steps
First Symetra offers a number of solutions to help you stay competitive in today's marketplace. To learn more, contact your benefits representative.
Stop loss policies are insured by First Symetra National Life Insurance Company of New York, New York, NY. Mailing address: P.O. Box 34690, Seattle, WA 98124. Policy form numbers is ELC-24000/NY 7/19. Coverage may be subject to exclusions, limitations, reductions and termination of benefit provisions.
1 Standard offering.