FAQs

Stop-loss insurance provides protection for health plans against catastrophic and often unpredictable losses by serving as a reimbursement mechanism for claims that exceed pre-determined levels. If your organization self-funds your employee benefits plan, stop-loss insurance allows your organization to avoid much of the liability arising from catastrophic losses.

A.M. Best, a U.S.-based rating agency, has given CBRM an “A” Rating (Excellent). This means we are deemed financially stable, with the ability to meet policyholder obligations.

Stop-loss coverage does not insure your employees, rather it is designed to protect your employee benefit plan from excessive losses due to catastrophic claims from your employees and their dependents.

CBRM offers stop-loss coverage to self-insured clients domiciled in Oregon, Utah, and Washington.

The CBRM team develops unique strategies to address specific client needs. While many variations are available, the two primary forms are “Individual” (also known as Specific) and “Aggregate” coverage. Individual coverage provides protection for the benefit plan if there is a catastrophic claim on any one individual. Aggregate coverage caps the dollar amount the employee benefit plan would be required to pay during a contract period.

The CBRM team will work with you, in partnership with your broker, to determine your plan’s needs, which may include both Individual and Aggregate stop-loss coverage.

To be eligible for reimbursement, the expenses must be clearly eligible under the employer’s benefit plan, and the loss must be covered in the stop-loss policy. Our stop-loss reimbursement will follow our partner ASO’s standard plan documents when utilized.

For organizations that have a bundled ASO product with one of our preferred health plan partners, we reimburse covered Individual stop-loss claims immediately. Advanced Funding is available with our select TPA partner.

Aggregate claims are reconciled and paid at the close of the contract period; however, our Monthly Reconciliation product may be available as an option to provide further stability.

We have developed practices and a philosophy which have resulted in a track record of industry-leading client persistency and renewal stability. CBRM has a dedicated stop-loss underwriting team and sales force boasting a significant amount of industry experience. We offer highly competitive stop-loss contracts that were developed with considerable broker input.

We offer integration with a dedicated ASO service center in the Northwest. A bundled ASO product approach, offered in partnership with our preferred health plans, provides a holistic stop-loss solution that is nimble enough to offer immediate reimbursement of Individual claims. We also have the flexibility to work with our select TPA partner(s) in some markets.