Stop loss insurance typically has two coverage levels that work together, Specific and Aggregate. The Specific will reimburse the Plan for claims that exceed a member’s Specific Deductible. Aggregate coverage reimburses when the total of all members’ claims exceed the Aggregate Deductible. Unlike many Stop Loss providers, TPAC does not force clients to include lasers. We are able to create solutions both with and without them, allowing us to create the best plan for the client’s needs.

A major concern about self-funding health insurance for employers is the volatility of monthly payments. Level funding solutions address this worry by providing an even monthly amount that is paid by the employer, with any remaining claims costs paid by the stop loss policy. TPAC offers both an aggregate-only level funded product with Spaggregate® and SmartShare®, a level funded stop loss product with both specific and aggregate attachment points.

As health care costs continue to rise, more employers are looking for cost containment solutions that work. In the right situation, employers who self-fund their health insurance can reap significant benefits. Self-funded plans typically have lower rate increases compared to traditional plans. Plus, savings are retained by the plan rather than disappearing into insurance company’s profits. Plans are also custom designed for specific workforces, giving meaningful benefits to employees directly related to what they actually need coverage for. There are many more benefits to self-funding, and we encourage you to contact us to learn more.

Controlling health care costs effectively is an important component of self-funding success. Reference-based pricing is a health care cost containment model that limits what a health plan will pay for certain high-cost services.