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Stop Loss Insurance

Protection for Self-Funded Employers

With more than 35 years in the Stop Loss insurance market, HM Insurance Group (HM) works to deliver smart solutions, exceptional performance and unparalleled support. Our Stop Loss coverage can be tailored to satisfy each client's level of risk tolerance, and you can trust that our underwriting experts are working to protect our policyholders’ financial well-being based on individual experience and group dynamics. With a wide range of deductibles and contract periods, our Stop Loss plans can be structured to meet specialized needs and mitigate potential claim risks.

Performance Distinction

As a leading Stop Loss carrier and direct writer, we work to optimize coverage through experienced risk management, excellent operational performance and successful cost containment practices. You can rely on quick, accurate payment of claims and an exceptionally high level of performance that enables you to focus on your own business goals. Talk with one of our experienced leaders to learn more about our approach to the market and build a relationship that lasts.

A Solid Contract

HM offers clients a Stop Loss policy that provides clarity, financial protection and choice. We know that the contract is the core of the carrier-client relationship and the foundation for mutual obligations. Our streamlined contract helps to ensure our policyholders know their coverage details. It’s written in language employers understand and offers choices for customized Stop Loss protection.

Claim Services from Dedicated Teams

Since we underwrite to pay claims, not to dispute them, you can count on responsive, timely administration of Stop Loss insurance claims. Our dedicated claims team uses streamlined processes to provide accurate and efficient reimbursement. Highlights include:

  • eClaims and low documentation submission options
  • Access to Centers of Excellence
  • Out-of-network discount negotiation services
  • Subrogation recovery
  • Collaboration on unusual/questionable services

Our Promise

We know that the heart of a smart business decision is the integrity of the transaction. Guided by knowledge and experience, we make sound, disciplined decisions to guard the financial health of our policyholders. When you work with HM, you can have confidence in the quality of what we are delivering.

Blog

Stop Loss Insights

  • Eight Months into Coronavirus – What Have We Learned, Where Are We Going?

    I went home from my office at 501 Penn Avenue in Pittsburgh, PA, around noon on March 18, 2020, after making sure one of our new employees had the computer equipment she needed to work from home. During my commute, I listened to a President Trump news conference on CNBC radio discussing the Coronavirus. At the time, I thought we would be home for six to eight weeks, and then we would be back in the office and things would return to normal. Well, a lot has happened since then.

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  • Predicting the Unpredictable

    The element of surprise. Facing the unknown. Making predictions. That’s what comes to mind when students interested in the actuarial profession ask me why I have enjoyed this career for the past 22 years. There are always problems to solve, but on any given day, I can never fully predict exactly what will come my way. Every morning, I start with my short list, but something unanticipated is usually on the horizon, case in point, the Coronavirus.

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  • Innovating for Next-Level Stop Loss Claims Processing

    You can probably imagine that working with more than 100 third party administrators (TPAs) means that HM Insurance Group (HM) receives tens of thousands of claim detail files every year. It’s a lot of data to manage. Files come into a secure, designated Stop Loss claims email box or via an FTP site. They are then saved to a corporate drive so our Claims team can format the TPAs’ Excel files into a format acceptable for loading into our claims system. The entire process takes a lot of manual work.  

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