Stop Loss
Stop Loss is a type of insurance that protects employers who self-fund their employee health insurance plans. Think of it as insurance for insurance - it sets a limit on how much an employer has to pay for healthcare costs. When medical expenses go beyond a certain amount (either for one person or the whole group), the stop loss insurance kicks in to cover the excess. This helps companies manage their risk when they choose to handle their own employee health coverage instead of buying traditional insurance.
Examples in Resumes
Managed Stop Loss policy renewals for 50+ self-funded employer groups
Negotiated Stop-Loss contracts resulting in 15% premium savings
Analyzed claims data to optimize Stop Loss attachment points for client portfolios
Typical job title: "Stop Loss Specialists"
Also try searching for:
Where to Find Stop Loss Specialists
Professional Associations
Job Boards
Professional Networks
Example Interview Questions
Senior Level Questions
Q: How would you evaluate a group's risk profile to determine appropriate stop loss levels?
Expected Answer: Should discuss analyzing claims history, employee demographics, industry type, and current healthcare trends to recommend appropriate individual and aggregate attachment points.
Q: What strategies would you use to manage a difficult stop loss renewal with increasing claims?
Expected Answer: Should explain approaches like analyzing alternative carriers, adjusting deductible levels, implementing cost containment programs, and negotiating with carriers using market leverage.
Mid Level Questions
Q: Explain the difference between specific and aggregate stop loss coverage.
Expected Answer: Should explain that specific stop loss protects against high claims from one individual, while aggregate stop loss protects against high claims from the entire group combined.
Q: How do you explain stop loss concepts to clients who are new to self-funding?
Expected Answer: Should demonstrate ability to break down complex concepts into simple terms and explain the financial benefits and risks of self-funding with stop loss protection.
Junior Level Questions
Q: What is the purpose of stop loss insurance?
Expected Answer: Should explain that stop loss protects self-funded employers from unexpectedly high medical claims by covering costs above certain thresholds.
Q: What basic information do you need to quote stop loss coverage?
Expected Answer: Should mention group size, claims history, current plan design, desired deductible levels, and basic census information.
Experience Level Indicators
Junior (0-2 years)
- Basic understanding of health insurance concepts
- Claims processing knowledge
- Customer service skills
- Data entry and reporting
Mid (2-5 years)
- Stop loss policy analysis
- Risk assessment
- Client communication
- Underwriting basics
Senior (5+ years)
- Advanced risk management
- Contract negotiation
- Market strategy development
- Team leadership
Red Flags to Watch For
- No knowledge of basic insurance terminology
- Lack of understanding about self-funded health plans
- Poor analytical skills
- No experience with claims analysis or risk assessment
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