Stop Loss Insurance

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Financial Protection for the Evolving Health Care Landscape

During uncertain times, it's critical to protect your company financially. If you have a self-funded benefit plan, stop loss insurance can help keep your business covered.

Stop loss from Cigna Healthcare SM * can help you save money and protect your cash flow from the growing risk of high-cost claims and new costly drugs and treatments.

What is stop loss insurance?

There are two types of stop loss insurance that Cigna Healthcare offers:

Individual Stop Loss (ISL)

ISL is stop loss coverage written to protect a self-funded medical plan by limiting an employer's claim liability on each individual to a set dollar amount per policy year.

Aggregate Stop Loss (ASL)

ASL is stop loss coverage written to protect a self-funded medical plan by limiting an employer's claim liability for their entire covered population to a set dollar amount per policy year.

For small to medium-sized employers, Cigna Level Funding ® and Cigna Healthcare Graded Funding include Individual and Aggregate Stop Loss automatically.

Types of Stop Loss Contracts

Incurred Contracts

We offer an Incurred Contract with an infinite terminal liability protection period where claims accumulate to stop loss limits based on the incurred date (i.e. date of service). With this contract type, eligible claims incurred during a policy year will accumulate together with no ISL limit reset, regardless of when the claim is paid.

The incurred contract is available with ISL and ASL, and:

Paid Contracts

We offer a Paid Contract where claims accumulate to stop loss limits based on the paid date. The paid contract covers eligible claims paid during the active policy year, so long as the claims were incurred after the original policy effective date. The paid contract is available with ISL and ASL.

Options for Stop Loss Contracts

We also offer additional stop loss contract options designed to satisfy your unique coverage needs.

Stop Loss Firm Quotes

Upon accepting our firm quote, your rates, terms and conditions become final and your premium for the policy period may never increase. We take on 100% of the covered claims liability.

Some firm quotes in the marketplace may only be willing to lock-in rates, which could leave room to alter other terms and conditions closer to the start date of your policy. Our early lock-in ensures that rate, terms and conditions are finalized — with no need for review of updated large claim information as your policy start date approaches. Signed disclosure forms are never required, even when you have employees with ongoing large claims.

Benefits of Integrating Stop Loss With Medical Plans

Stop loss insurance integrated with a self-funded medical plan ensures alignment between policies and enables:

Stop Loss Training and Continuing Education

Cigna Healthcare offers stop loss training courses for brokers and consultants seeking continuing education credit. We can also tailor an interactive session for employers that wish to learn more about self-funding and stop loss insurance.

More Cost Control Strategies

Explore Other Products

* Offered by Cigna Health and Life Insurance Company

1 For those on a paid contract, maturation may apply at first renewal.

2 Stop Loss Reimbursement Notifications are issued for claims with medical payouts of $250k+.

Policy provisions and availability may vary by location and is subject to change. All stop loss insurance policies and group benefit plans contain exclusions and limitations. For costs and details of coverage, contact your Cigna Healthcare representative.

Cigna Healthcare products and services are provided exclusively by or through operating subsidiaries of The Cigna Group, including Cigna Health and Life Insurance Company (Bloomfield, CT), or its affiliates. In Utah, all products and services are provided by Cigna Health and Life Insurance Company (Bloomfield, CT). Policy forms: OK – HP-APP-1 et al., OR – HP-POL38 02-13, TN – HP-POL43/HC-CER1V1 et al. (CHLIC); GSA-COVER, et al. (CHC-TN).

© 2023 Cigna Healthcare.

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Individual and family medical and dental insurance plans are insured by Cigna Health and Life Insurance Company (CHLIC), Cigna HealthCare of Arizona, Inc., Cigna HealthCare of Illinois, Inc., Cigna HealthCare of Georgia, Inc., Cigna HealthCare of North Carolina, Inc., Cigna HealthCare of South Carolina, Inc., and Cigna HealthCare of Texas, Inc. Group health insurance and health benefit plans are insured or administered by CHLIC, Connecticut General Life Insurance Company (CGLIC), or their affiliates (see a listing of the legal entities that insure or administer group HMO, dental HMO, and other products or services in your state). Accidental Injury, Critical Illness, and Hospital Care plans or insurance policies are distributed exclusively by or through operating subsidiaries of The Cigna Group Corporation, are administered by Cigna Health and Life Insurance Company, and are insured by either (i) Cigna Health and Life Insurance Company (Bloomfield, CT). The Cigna Healthcare name, logo, and other Cigna Healthcare marks are owned by The Cigna Group Intellectual Property, Inc.

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La aseguradora publica el formulario traducido para fines informativos y la versión en inglés prevalece para fines de solicitud e interpretación.

The insurer is issuing the translated form on an informational basis and the English version is controlling for the purposes of application and interpretation.