1. 475 POINTS
    Barry Cohn
    President, RGEB Employee Benefits, Los Angeles
    A stop loss means exactly what it implies, "it stops your loss" and the insurance carrier picks up all other costs during that calendar year.  For individuals that have health insurance a stop loss is also known as the annual out-of-pocket maximum.  After you reach the out-of-pocket maximum in a calendar year the insurance carrier pays the rest of the claims.

    In a self-insurance situation where a company pays the claims up to a certain dollar amount the "stop loss" is the most the employer will pay in any year after which the insurance carrier will pay the remaining claims.
    Answered on July 23, 2014
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