stop-loss health insurance plans
stop-loss health insurance plans, Say so long to the risks of self-financing. With Aetna stop-loss insurance, you can limit high-cost claims and get a full menu of features to boost plan value for health, predictability, and protection.
stop-loss basics
With a stop loss, you get all the typical benefits of self-funding, like flexible plan designs, better cash flow, and exemption from state health plan regulations. Plus lots of outlier benefits, like a cap on high-cost claims and options to reduce exposure. All backed by our solid service and support
plan highlights
- One stop for the medical plan and stop loss, for easier administration
- Self-reimbursement for high-cost claims as soon as they happen
- Coverage for most claims, including transplants and substance abuse
- Fixed monthly premium and preset liability limit
- individual and combined coverage options
More plans designed for you
With Stop-loss function, which has covered achieved claims protection. Now that you complement the financial coverage with one of our quality medical plans, all built with health security in mind.
- Medicare group insurance
- Individual Medicare Plans
- compensation plans
- Exclusive Provider Organization (EPO) Plans
- Preferred Provider Organization (PPO) Plans
- Health maintenance organization (HMO) plans
Options for holistic health
Add health to your entire benefit plan with our range of dental, vision and other ancillary benefits. They are available stand-alone or with any medical plan.
- dental plans
- vision plans
- Pharmacy
- Supplemental plans
- Aetna Whole Health
Count on us to achieve the right combination
Aetna is the best place to find the plans, programs, services, and management you need to keep your business strong and healthy.
Client Services
Keep your members healthy and engaged with programs and services that keep whole health in mind.
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for simple administration
Find quoting, enrollment, and reporting tools to make the process easier for plan sponsors and insurance agents.
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self financed security
Protect your business and bottom line with Aetna Stop Loss.
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Legal notices
“Aetna” is the trade name used for products and services offered by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (referred to as “Aetna”).
Health insurance and benefit plans have exclusions and limitations.
What is Stop Loss?
The annual out-of-pocket maximum for CoinsuranceWhen we talk about major medical expenses, ASSA compensates a percentage and the insured assumes the difference. In high-cost claims, the insured’s share could be very high; This clause protects you in this type of claim, by establishing a maximum amount of disbursement by the insured per policy year. In other words, if an insured ASSAmedic Plan had a significant expense, for example, a surgery with a total cost of B/.60,000.00, the client would have to pay B/.12,000.00 as coinsurance. Thanks to this clause, the insured will only pay B/.7,500.00 (after the annual deductible, if applicable) and the company will continue to cover 100% of all remaining expenses during the policy year.
