Stop-Loss Insurance

Definition


Stop-Loss Insurance (Canada): A specialized policy purchased by a plan sponsor (such as an employer, union, or government body) who self-insures employee health or dental benefits. The policy provides two types of protection. First, it limits the annual financial exposure of the plan sponsor by reimbursing any claims that exceed a predetermined dollar threshold (the “specific deductible”) suffered by any single plan member. Second, it limits the sponsor’s overall annual liabilities by reimbursing costs that surpass a separate threshold (the “aggregate deductible”) for the entire plan. These policies are issued by Canadian-licensed insurers and comply with provincial health insurance laws and federal excise-tax rules.

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Coverage Type

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