What purpose do "stop-loss insurance" policies serve?

Stop-loss insurance policies are designed to protect organizations, particularly self-insured employers, from high claims costs by capping total losses. This type of coverage establishes a limit on the amount the insurer will pay out for claims incurred by the policyholder. When the cumulative costs of claims reach a pre-defined threshold, the stop-loss coverage activates, ensuring that the policyholder does not face financial ruin due to unexpectedly high medical or insurance costs. This provides a safety net that allows businesses to manage their risks more effectively while still taking on some level of self-insurance.

This mechanism is particularly beneficial for employers who choose to self-fund their employee health benefits, as it allows them to predict their financial exposure and budget accordingly, while still protecting against catastrophic claims. By capping potential losses, stop-loss insurance enables employers to tackle the benefits-related costs more confidently without the fear of incurring unmanageable expenses.