Stop Loss Underwriting

Dedicated underwriters work directly with our TPAs
to provide Stop Loss quotes, sell business and
handle renewals.

Our quick, efficient underwriting process helps you
meet your clients' needs for specific and/or aggregate claims protection.

Basic underwriting specifications

• Single employer firms with 100+ full-time covered employees*
• Specific Stop Loss is available as a stand-alone product
• Minimum specific deductible as low as $20,000*
• Minimum specific deductible of 10%-15% of expected claims or 150-200 times the number of covered employees
• Aggregate Stop Loss must be packaged with Specific Stop Loss
• Minimum aggregate deductible of 125% of expected claims

Available Stop Loss riders

• Aggregating specific deductible
• Family deductibles
• Specific and aggregate terminal liability
• Specific and aggregate accommodation

Employer characteristics

• An existing employer/employee relationship
• Single employers only – no association groups, METs, MEWAs or employer leasing firms
• In-force group medical coverage, preferably self-funded
• No more than three insurance carriers in the last five years
• Participation level of 100% when employer pays 100% of premium
• Minimum participation level of 75% of those electing coverage when the employee pays a portion of the premium
• Minimum 50% participation of total employer group
• Financially stable
• Less than 10% retirees under age 65
• Less than 5% in COBRA

Plan Eligibility Provisions

• Minimum 30-hour workweek
• Active-at-work provision, waived on approved disclosure
• Preexisting limits applied, when not included in plan document
• Plan includes utilization review, precertification and large case managment

Ineligible Industries

Access a listing of ineligible industries for Mutual of Omaha TPA Stop Loss.

Disclosure

Lock in based on approval of disclosure information 30 days or less prior to the effective date. This may be extended to 45-60 days based on group specific circumstances.

Submitting new business

TPAs must be approved, licensed and appointed with Mutual of Omaha and/or United of Omaha Life Insurance Company.

Contact Us

For more information about our underwriting or TPA Stop Loss products, submit a request.