Excess Risk (Stop Loss)

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Excess Risk (Stop Loss)
Selling Tips
For Insurance Producer Use Only
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Benefits of Stop Loss Insurance

• Reduces liability for health care costs
• Minimizes financial risk
• Helps improve employers cash flow
• Serves as a buffer against rising health care
  costs
• Maintains the advantages of self funding
• Employer can customize plan features
• Provides long-term cost control

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Specific vs. Aggregate Stop Loss

• Specific Stop Loss
• Designed to protect the employer from large
  medical claims from any one individual by
  providing coverage for liabilities above a
  specific dollar amount set by the employer
• Aggregate Stop Loss
• Protects employers from higher than anticipated
  claims for the group as a whole.

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Specific Stop Loss Benefits and Features

• Employer Benefits
• Minimum deductible of 35,000
• Variable lifetime maximums
• Comprehensive selection of contract types
• MOMM program
• Embedded Features
• No lasering required
• Disclosure forms on new cases only
• Specific advance assures prompt reimbursement
  by payor (claim minimum is 1,000)

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Aggregate Stop Loss Benefits and Features

• Employer Benefits
• Standard attachment point is 125
• Standard minimum aggregate attachment point is
  85
• Annual benefit maximum 1,000,000
• Broad range of contract types available
• Sold with Specific Stop Loss
• Embedded Features
• Attachment point finalized with 10 months
• of claims

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MOMM Program

• What is Maximized Outcome Medical Management
  MOMM?
• Its KMG Americas brand of medical management
  that keeps patient care in the best possible
  balance always seeking to maximize clinical and
  financial outcomes.
• Complement your existing managed care with many
  free or below market price consultative services.
• Deliver highly skilled, specialized, expert
  guidance in complex, high cost cases.
• Save you and your clients money through exclusive
  preferred pricing and even generate income for
  your company through
• Negotiation Rewards
• Case Management Rewards
• Transplant Rewards
• Predicative Modeling Rewards

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The KMG America Difference

• Personalized service your clients dictate in
  a stop loss provider. We have experienced
  underwriters who will help develop intelligent
  solutions and meet specific customer needs. You
  will appreciate our
• Team of managed care professionals on staff
• Access to underwriters and senior management
• Prompt quotes
• Timely claims reimbursement
• Comprehensive claim management

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Every effort has been made to ensure that
information contained in this document is
accurate but technical inaccuracies or
typographical errors may occur. In addition,
this material may be dated and subject to change
without notice. Please be sure you are using the
latest version of this document. If in doubt,
please contact KMG America directly at
1-888-313-4534. Excess Risk is Kanawha
Insurance Company Policy Form 9000 6/05.
For Insurance Producer Use Only