OptumHealth Specialty Benefits Stop Loss is a national expert in excess risk products and stop loss management services, including both Specific and Aggregate coverages with a full range of contract options:

• Broad deductible range for Specific coverage:  $20,000 to $1 million
• No mandated “lasering” and no disclosure requirement at renewal
• Flexible financial options
• Reimbursement of medical case management fees, once Stop Loss level reached

Our Stop Loss offerings include access to these value-added services and optional programs to help manage the high costs of managing catastrophic health conditions:

• Centers of Excellence: We automatically include access to our credentialed Centers of Excellence Network Facilities for transplant, cancer, kidney disease and other catastrophic health conditions.
• Step-Down Deductible: Specific deductible reduced by 15 percent when a claimant accesses a pre-approved OptumHealth Center of Excellence facility at the contracted rate.
• Medical Management: Our in-house medical management experts consult with our underwriting and claims teams, as well as advise TPAs to help manage costs and improve outcomes
• Optional Managed Transplant Program:  We also offer a fully-insured carve-out option that covers transplant-related costs.