seCUREme
Stop Loss Insurance
The seCUREmeComprehensive Stop Loss Plan is designed for Self-Funded or Third Party Administrated Benefit Plans for businesses with 5 employees or more, often referred to as a “groups”. seCUREme has been created to mitigate the medical financial risk of the employer while still being able to offer their employees attractive and flexible Traditional Extended Health Plans or Health Spending Account plans. And a huge bonus to the Employer is that seCUREme Stop Loss has been priced with Group Rates!
A medical Stop Loss Insurance policy protects employers from assuming all the liability for losses that result from an unexpected number of claims – either from an individual employee or the entire employee group. Under the seCUREme Stop Loss Insurance policy, you are not responsible for claims that exceed certain pre-set limits for the policy year, such as defined benefits per person or annual benefit maximums. When claim expenses go above these defined limits, your Stop Loss insurance will then assume the liability based on your contract. The seCUREme Stop Loss plan will mitigate the employer’s financial risk when self-funding a Tradition Extended Health plan by providing insurance protection against unpredictable and catastrophic claims.
Most often these large catastrophic claims are due to unexpected needs for expensive medications for either short term or extended periods of time. seCUREme Stop Loss insurance allows employers to provide extended benefits to cover these situations within a self-funded plan, while eliminating the financial risk to the business. Small and mid-size businesses can now offer self-funded extended health benefit plans that previously only large companies could afford.
seCUREme Stop Loss insurance from Health Risk Services, covers a comprehensive range of health-related services from emergency ambulance rides and hospital stays to paramedicals, hearing, dental and various other health needs. It can include or exclude Emergency Medical Travel Insurance for travel outside of the Province or Country whether it be for Business or Pleasure!
Most importantly, seCUREme Stop Loss insurance will cover the cost of expensive or long-term prescription drugs – often the most devastating financial concern to a family! You can choose either 80% or 100% coverage and all medications including Generic, Brand Biologic or Bio-Similar Drugs are covered. Biologic and Bio-Similar Drugs are on a Pre-Authorized basis only.
seCUREme Stop Loss insurance attaches to your Traditional Extended Health Plan or Health Spending Account by your selection of one of these Deductibles:
$2,500.00, $5,000.00 or $10,000.00
Like the deductible on Auto Insurance where the Insured is responsible for paying the deductible amount prior to the Insurance commencing, the seCUREme Stop Loss deductible amount purchased is first paid through the Traditional Extended Health Plan or Health Spending Account and then the seCUREme Stop Loss benefits become payable. The deductible chosen will determine the Monthly cost of your seCUREme Stop Loss Plan.
If you have had Stop Loss insurance on a plan prior to purchasing seCUREme Stop Loss, we may be able to Grandfather all the current employees from the existing plan to your new seCUREme. If you have not had prior Stop Loss insurance on your Group Benefit Plan, then your group will be underwritten based on past and present claims experience.
Many of the seCUREme Stop Loss Insurance benefits will reimburse at 100% up to the specified plan maximum. Some of the benefits such as the Paramedicals and Dental reimburse at the specified levels as per the Plan Description.
seCUREme Stop Loss Insurance provides sustainable financial security with added benefits, convenience and lower premium costs. seCUREme Stop Loss– a terrific way to protect yourself, your employees and your business!