Standard Stop-Loss Employer Disclosure Form Endorsed

Self-Insurance Institute of America ( www.SIIA.org) and Society of Professional Benefit Administrators ( www.SPBATPA.org) have endorsed a standardized stop-loss disclosure form, which also includes ICD-9 codes. The documents are intended to help facilitate the sharing of health data information between self-insured entities/TPAs and stop-loss insurers/MGUs for the purpose of medical stop-loss underwriting.

Stop-Loss Carriers and MGUs Adopt the Standardized Form

The list below represents an estimated $3.3 Billion in Stop-Loss premium. Assuming a medical self-funded community Stop-Loss market of $4 Billion, then over 80% of the market has adopted the form.

If you are a Stop-Loss carrier or MGU that has adopted the standard disclosure form, please let us know at Info@MyHealthGuide.com.

  • BEST Re on behalf of US FIRE & BEST LIFE
  • Cairnstone Re
  •  HCC Life
  •  HMA MGU, LLC, MGU
  • Independence Holding Company (Standard Security Life Insurance Company of New York, Madison National Life and Independence American Insurance Company)
  • Intermediary Insurance Services, Inc. (IISI), MGU on behalf of QBE Insurance Company and American National Life Insurance Company of Texas
  • J. Allan Hall & Associates, Inc., MGU on behalf of their underwriting facility, Lloyd’s of London
  • Medical Excess
  • Medical Risk Managers, MGU
  • National Benefit Resources, MGU on behalf of UnitedHealth Group insurance companies
  • R. E. Moulton, Inc. / American United Life Insurance Company (OneAmerica Companies)
  • RMTS, LLC, MGU on behalf of their carriers Nationwide Life Insurance Company, Gerber Life Insurance Company, and Trustmark Insurance Company (as filed)
  • Spectrum Underwriters, MGU
  • Star Line Group, MGU on behalf of QBE Insurance Company, Nationwide Life Insurance Company and Lloyd’s of London.
  • Stop-Loss Concepts, Inc., MGU on behalf of their carriers, Gerber Life Insurance Company and QBE Insurance Company.
  • Swiss Re Commercial Insurance
  • Zurich North America

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