Medical Stop-Loss

Medical stop-loss coverage is a product that provides protection for a health plan against catastrophic or unpredictable losses.

The Palmetto Healthcare Stop-Loss Program (PHSLP) is a unique medical stop-loss offering that was established in 2011 with a retrospective funding model where members pay actual costs – eliminating much of the profit and removing the surplus and margins found in commercial stop-loss. Risk is spread across a pool of participating members, lessening the effects of this volatile line of coverage. Members have recognized significant savings compared to the commercial stop-loss market, and members who have self-insured this risk in the past, appreciate the smoothing of risk created by a larger program.

Medical stop-loss claims administration, underwriting and risk management services are provided to members of PHSLP under a contract with Antum Risk and through business alliances with other best-practices companies.

“We estimate that the County will save more than 50% on the cost of our stop-loss coverage this year alone thanks to joining PHSLP. We like the program’s retroactive funding structure and having the volatile risk spread across a pool of participating organizations. As members, we also appreciate the transparency related to its operations and cost.”
- RITA DAVIS, FINANCE MANAGER, ANDERSON COUNTY

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