Employee Benefits / Workplace Benefits

Stop Loss Insurance

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You cover your workers’ health costs. We cover your business.

Employers today have more choices – and questions – than ever before about the best way to provide their employees with the health care coverage they want and need.  

Included in that is a decision about how to finance that expense. Employers offering medical benefit plans have two choices as to how to fund them:

  • Fully insured plan – With fully insured plans, employers pay a fixed monthly amount to the insurance company, which provides the medical benefits and pays any claims.

  • Self-funded plan – Employers cover the costs of their employees’ medical plan and pay a fee to a plan administrator, who performs duties such as claims processing. In this case, the employer takes on 100% of the risk of paying their employees’ medical claims. Employers that self-fund their medical plans do so in order to benefit from cost savings because they only pay medical expenses when they’re actually incurred. Self-funding also improves their cash flow, reduces taxes and expenses, and provides flexibility in their plan design, which ultimately allows employers to provide the coverage their employees truly desire.

The self-funded plan is becoming a popular choice - approximately 61% of US employees covered by employer-sponsored health insurance are in firms that self-fund.1 Stop loss insurance is designed to protect self-funding employers from the high costs that may occur due to unexpected or catastrophic claims from employees.

Without stop loss insurance, the employer is fully responsible if medical claims are higher than expected. Even one large claim could create a serious financial drain on your company, particularly if you own a smaller or mid-size firm.

With this insurance, you pay a predetermined amount on employee medical claims. Any amount beyond that would be covered. While this insurance is traditionally for larger employers, Guardian also offers stop loss protection to mid-sized and small business owners.

Stop Loss Insurance protects employers

  • Options for the way you want to provide coverage. You can choose a max dollar amount you’ll cover for each person in your plan every year, set a dollar amount that you’ll cover for the combined cost of all employee claims that year, or both. 

  • Flexibility to tailor your plan. Based on your company size, financial situation, cash flow, risk tolerance, number of employees, and other factors, we offer options that can improve your cash flow and provide more cost savings.

  • Fast claims processing. You’ll receive payments quickly for your claims, so you’ll have more money available to run your business. And we pay your claims with no minimum threshold, meaning that you don’t have to meet a minimum before we reimburse you. 

WHY GUARDIAN FOR WORKPLACE BENEFITS?

At Guardian, we offer a full suite of benefits that can truly make a difference for your employees by protecting their income or savings, or even their health.  We focus on benefits, so you can focus on running your business.

MORE ON GUARDIAN’S BENEFITS PROGRAMS

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1 2013 Kaiser Family Foundation study

Guardian's Stop Loss Insurance is underwritten and issued by The Guardian Life Insurance Company of America, New York, NY. Products are not available in all states. Policy limitations and exclusions apply. Optional riders and/or features may incur additional costs. Plan documents are the final arbiter of coverage. Policy Form #GP-1-SL-13

Guardian’s Stop Loss Insurance is available in all states except HI, ND and WA.