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.

“As one of the founding members of the program, I am very pleased with our experience in PHSLP. Self Regional Healthcare has saved between 10-25% annually as a member of the program over the past eight years. We like the program’s retroactive funding structure and having the volatile risk spread across a pool of participating healthcare organizations. We also appreciate that membership provides us direct input into the coverage we receive and transparency related to its operations and cost.”

- MIKE DIXON, VICE PRESIDENT OF HUMAN RESOURCES, SELF REGIONAL HEALTHCARE

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