Medical Stop Loss Insurance

Make self-funding more managable and affordable.

Taft-Hartley plans face a unique set of circumstances with some of the Affordable Care Act’s (ACA) requirements. With the law’s mandate to remove plan coverage limits, many face the challenge of maintaining quality coverage, benefit selections and access to service providers for their plan members.

With over 85 years of experience protecting Taft-Hartley plans, Union Labor Life’s team of experts are dedicated to tailoring stop loss insurance arrangements that comply with ACA requirements, and offer broader coverage options and access to some of today’s leading professionals in the medical cost containment industry.

Standard coverage benefits include:

  • Stand-alone specific or specific and aggregate available
  • ACA compliant annual coverage maximums to unlimited.
  • Full range of aggregate and specific contracts including—12/12, 15/12, 12/15 or on a paid basis.
  • Minimum specific deductible of $40,000 to a maximum of $1 million or more.

Standard policy features include:

  • Multi-year premium lock options to help plan sponsors better predict costs by locking in renewal rates for multiple years on specific stop loss coverage—OR
  • No new laser at next renewal guarantee on specific stop loss coverage.
  • Coverage includes approved clinical trials beginning in 2014.
  • Medical management provisions to help manage claim payments and identify potential risks.

Value-added services to help contain costs:

From helping plans properly negotiate service fees with network providers and third-party administrators, to assisting in identifying potentially fraudulent billing practices and abuses, Union Labor Life works in partnership with policyholders to help them achieve the level of control they need to manage large claim costs, maximize benefits and optimize plan performance. Types of cost containment programs available to policyholders include:

  • Bill re-pricing
  • Discount negotiations
  • Bill reviews and line-item audits
  • Case management
  • Medical reviews
  • Specialty care management

Learn more on how our large claim experts help plans contain costs to help them maximize benefits for plan members

Union Labor Life's Group Stop Loss Programs:
A group purchasing approach with greater predictability.

Qualified plans can choose to participate in one of Union Labor Life’s tailored group stop loss insurance programs, offering some of the same standard benefits and features and cost containment programs. Programs are tailored to meet each fund’s insurance needs and offer the opportunity for participating funds to earn dividends based on annual premium volumes and the participants’ favorable claims experience.

For more information on Medical Stop Loss insurance (PDF) and our Cost Containment Program (PDF) please contact our Vice President of Group Sales, Larry Paradise at 630.743.4252.

For information and resources on the Affordable Care Act and its impact on Taft-Hartley plans, visit: ullico.com/reform-resource.

The Union Labor Life Stop Loss program offers The Union Labor Life Insurance Company (rated B++ (Good) by A.M. Best Company as of 7/22/2016) policies in all 50 states and the District of Columbia, the Fidelity Security Life Insurance Company policies in 49 states and the District of Columbia and Fidelity Security Life Insurance Company, New York in New York. Fidelity Security Life Insurance Company and Fidelity Security Life Insurance Company, New York have both been rated A- (Excellent) by A.M. Best as of 3/31/2016.

Ratings

A.M. Best rates the financial strength of insurance companies and gives an indication of how that company may be expected to perform in the future.

The Union Labor Life Insurance Company’s solid financial position was reaffirmed by A.M. Best Company with a B++ (Good) “Stable” Outlook rating as of 7/22/2016.


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