Missouri Statement of Specific and Aggregate Excess Insurance Coverage is a type of insurance policy that provides excess coverage beyond the limits of a primary policy. It is designed to protect an insured party from catastrophic losses due to large claims or multiple claims. It is most commonly used by companies and organizations to protect their assets and finances from unusually large or unexpected expenses. The Missouri Statement of Specific and Aggregate Excess Insurance Coverage is divided into two types: specific excess and aggregate excess. Specific excess coverage applies to individual claims that exceed the limits of the primary policy. Aggregate excess coverage applies to the total amount of claims paid out within a specified period, such as a year, and is designed to protect against multiple claims that exceed the primary policy's limit. The excess coverage can be purchased in increments of $1 million or more and is generally written on a 'following form' basis, meaning that it follows the same terms and conditions as the primary policy.
Missouri Statement of Specific and Aggregate Excess Insurance Coverage
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FAQ
Individual Stop Loss (ISL) is a stop loss policy written in conjunction with a self-funded medical plan, limiting the employer's liability on each individual to a set dollar amount per policy year.
With stop loss insurance, the employer's out-of-pocket is capped at an agreed amount. If costs exceed that threshold, any additional expenses are covered by the stop loss policy. It's important to note that this coverage comes in the form of reimbursement, so employers are still responsible for initial payment.
By choosing a self-funded plan with stop-loss coverage, employers limit their risk, protect themselves against high claims, and have the potential for great savings. In some instances, they may even receive a refund in years claims are lower than anticipated.
Individual Stop Loss (ISL) is a stop loss policy written in conjunction with a self-funded medical plan, limiting the employer's liability on each individual to a set dollar amount per policy year.
Specific stop-loss insurance If any claims from individuals go over that amount, the policy reimburses you for the excess. For example, if you set your liability cap at $150,000 per person for the policy year, and a participant's total eligible claims come to $158,000, your policy will reimburse you $8,000.
The threshold is calculated based on a certain percentage of projected costs (called attachment points)?usually 125% of anticipated claims for the year. An aggregate stop-loss threshold is usually variable and not fixed. This is because the threshold fluctuates as a percentage of an employer's enrolled employees.
In a nutshell, what does it mean to be self-insured? Being self-insured means that rather than paying an insurance company to pay medical, dental and vision claims, we pay the claims ourselves, using a third-party administrator to process the claims on our behalf.
Employers liability limits can often be increases to a maximum of $5 million for each part of coverage. An Umbrella policy may also provide additional coverage over employers liability insurance. Workers' compensation coverage in monopolistic states does not provide coverage for employers liability insurance.
Specific Stop-Loss is the form of excess risk coverage that provides protection for the employer against a high claim on any one individual. This is protection against abnormal severity of a single claim rather than abnormal frequency of claims in total. Specific stop-loss is also known as individual stop-loss.
