7/30/2019 Stoploss Brochure En

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Catastrophicclaimsprotection Individualcoverageperfamilymemberupto

$1,000,000perlifetime DrugandExtendedHeathCareorDrugOnly

options Attachmentlevelsof:$10,000,$15,000,$20,000and

$25,000 Attachmentlevelsinexcessof$25,000willbe

consideredonaclientspecicbasis Nationalcoverage IncludesSpecialAuthorizationforSpecialty*drugs

Minimumgroupsize-twenty-ve(25)primarylives Anindividualclaimslistingperfamilymemberforthe

mostrecenttwelve(12)months Forindividualswithinthegroupwhoseclaims

experienceinthepasttwelve(12)monthsisinexcessof,ortrendingbeyondseventy-vepercent(75%)ofthegroupattachmentlevel,theattachmentlevelwillbeadjusted.

Iftheindividualclaimsexperienceisunavailable, thefollowingisrequired:

1. two(2)fullyearsofaggregateclaimsinformationincludingnumberofinsuredmembersperyear

2. aminimumstop-losslevelof$10,000forDrugandExtendedHealthCareandforDrugsOnlyisavailable.Newlevelsmaybeavailableone(1)yearafterapplicationsubjecttoreviewofexperience.

Completedandsignedapplication HealthServiceSpendingAccount(HSSA),CostPlus,

andUnlimitedBenetsprogramsareexcludedfromcoverage

PLANHIGHLIGHTS CONSIDERATIONS

SECUREPAKSPECIFICPLUS TM

SECUREPAKULTRATM

SECUREPAKAGG

SecurePakTM

Stop-lossInsurance

The following Plan Highlights and Considerations apply to

both SecurePak Specifc PlusTMand SecurePak UltraTM

Protectionagainstcatastrophiexpectedclaimingfrequency

Groupcoverageupto$1,000,0 Claimliabilityislimitedtothe

level Attachmentlevels:110%*,115

150%ofprojectedclaims(*on

of100ormoreprimarylives) DrugandExtendedHealthCa

options

Nationalcoverage

Minimumgroupsize-twenty- Aminimumofthree(3)yearso

experiencebybenetline

IndividualandFamilyvolumeseachyearofexperience

DeterminationoftheStop-Lo

bytheInsurersauthorizedre Completedandsignedapplica HealthServiceSpendingAcco

andUnlimitedBenetsprogracoverage

Specicattachmentlevelsaresetforindividualswithclaimsexceedingortrending

beyondseventy-vepercent(75%)ofthegroupattachmentlevel at application & 1st renewal.

Specicattachmentlevelsaresetforindividualswithclaimsexceedingortrendingbeyond

seventy-vepercent(75%)ofthegroupattachmentlevelat application only. No adjustment at

rst renewal is performed.

SecurePakAggregateTM

orwithoutSecurePakS

SecurePakUlt

The following Plan Hi

Considerations apply to Secu

PLANHIGHLI

CONSIDERAT

*Specialtydrugsarethosedrugsnormallycostinginexcessof

$10,000peryearordrugsthatwhenusedincombinationtherapy

withotherdrugs,normallyhaveacostinexcessof$10,000peryear

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