Stop Loss Insurance

Stop loss insurance protects your business from catastrophic or unpredictable claims. Sana includes this coverage in our level funding arrangements because we know predictability and peace of mind are essential to our customers. 

Important Terms

An attachment point is the dollar amount of medical claims after which the stop loss coverage begins reimbursement, similar to a deductible.

  • The number of enrolled employees and other factors determine the attachment point calculation.
    A policy with an attachment point of $10,000 would begin reimbursing claims at $10,001.
  • There are two types of stop loss coverage included in your stop loss policy: specific stop loss and aggregate stop loss.

Specific stop loss coverage applies when a single employee has a medical event requiring extremely costly care. The policy will reimburse the member's claims once they exceed the individual attachment point.

Aggregate stop loss coverage applies when the cumulative claims expense of all the health plan participants exceed the aggregate attachment point during the policy's contract period.

Both the aggregate and specific attachment points are listed in the Stop Loss tab of your admin account.

Your Coverage

  • Stop loss coverage is included in your initial sales proposal and monthly premium, and is not billed separately.
  • We will need an additional signature after Open Enrollment for your stop loss coverage to begin.
  • Your monthly premium will not fluctuate during the plan year with this coverage, no matter what happens with employee claims. If claims exceed the stop loss policy's attachment points, the policy will automatically kick in and pay on your company's behalf.
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