You are here > Tools > Glossary

Commonly Used Insurance Terms

Term Description
Aggregate Stop-Loss Aggregate stop-loss insurance limits the overall annual claims liability by reimbursing the company when the claims paid for the self-funded plan, as a whole, exceed a certain preset level.
Attachment Point For aggregate stop-loss insurance it is the point at which the stop-loss insurance carrier reimburses the employer based upon the cumulative total of claims paid within a contract period.
Contract Period The time covered under a contract designating when a claim is incurred and when the claim must be paid to qualify for reimbursement.
Plan Year The 12-month period in which deductible and co-insurance accumulates toward a plan participant's out of pocket maximums.
Reinsurance Another term for stop-loss coverage.
Run-In Claims incurred prior to a plan year but reported after the end date of the plan year. These claims can be paid under the "current year" contract that includes the run-in period and the current plan year claims.
Run-Out Claims incurred during a plan year but reported after the end date of the plan year. These claims can be paid under the "prior year" contract.
Specific Stop-Loss Individual or specific stop-loss insurance provides reimbursement in the event an individual plan participant has claims that exceed the specific deductible during a contract period.
Specific Deductible The amount of claims for which the plan is responsible for on any one individual in a contract period. You may also have an Aggregating Specific, which applies a corridor of claims between the actual Specific Deductible and when the carrier begin to be responsible for claims.
Self-Insured Plan Refers to an employee benefit plan where the employer alone is liable for all benefits provided for under the provisions of the plan.
Self-Funded Plan Refers to an employee benefit plan where the employer will pay a certain portion of the benefits liability and an insurance company will pay the excess balance, if any.
  
Site Search

  
Corporate Offices
Commercial Group Intermediaries
16 Executive Court
Suite 4
South Barrington, IL  60010

Main Number:  (847) 713-4700
Fax:  (847) 713-4701

Contact Via The Internet