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Product Enhancements

Tailor your stop loss insurance solutions

Product enhancements can be a helpful addition to further tailor a stop loss insurance solution that effectively manages an employer's risk tolerance and coverage preferences.

iiSi is pleased to offer a comprehensive suite of products that can supplement coverage and offer additional tools to build an effective risk management strategy. These enhancements include:

  • Simultaneous Specific Reimbursement - Designed to provide cash flow relief by coordinating payment of specific stop loss reimbursements to the contract-holder in conjunction with the plan’s payment of the eligible claim.
  • Specific Terminal Liability Option - Allows for flexibility for contract-holders that may wish to consider transitioning to a fully-insured plan by extending certain specific stop loss benefits at the end of their contract period.
  • Family Specific Deductible - Amends the stop loss contract by applying the specific deductible to a family unit rather than to the covered employee and each dependent individually.
  • Specific Benefit Rate Stabilization - Provides assurance to the contract-holder that, at renewal, no new lasers will be issued and any potential rate increase will be capped at a pre-determined threshold.
  • Specific Benefit “Gapless” Bridge Renewal - Provides contract-holders with added protection against gaps in coverage when eligible specific claims are incurred during the contract period, but paid outside of the run-out period.
  • Monthly Aggregate Accommodation - Stabilizes cash flow by establishing certain aggregate benefits each month rather than waiting until the end of the contract period.
  • Aggregate Terminal Liability Option - Allows flexibility for contract-holders that may wish to consider transitioning to a fully-insured plan, by extending certain aggregate stop loss benefits at the end of their contract period.
  • Reference Based Pricing Extension - Provides assurance to the contract-holder that eligible Reference Based Pricing claims can still be considered under the applicable specific and/or aggregate stop loss benefit even if payment of the claim is delayed due to a provider appeal.
  • Experience Refund - Provides an opportunity for contract-holders to recoup a portion of specific stop loss premiums paid during the contract period for the specific stop loss benefit if certain loss ratio parameters are met at the conclusion of the contract period.
  • Limited Exclusions - Eliminates potential conflicts between the limits and exclusions in the stop loss contract and in the contract-holder’s benefit plan by “mirroring” the limits/exclusions language in the plan document.

**Not all products available in all states.**

Please reach out to your Regional Marketing Director for additional details and eligibility on any of our product enhancement offerings.

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