With typical employer stop-loss coverage, the employer pays all claims for members below the specific deductible and up to the aggregate deductible. Between overall expected claims and the aggregate deductible there may be a wide range of risk for the employer. A specific deductible protects against unexpected catastrophic claims. Less obvious is the threat from higher frequency of lower dollar claims.
The risk of higher frequency and higher volatility claims is very real and often unprotected. In many cases it represents greater exposure to the self-funded employer than the cost of catastrophic claims.
With its precision risk approach, Coefficient offers protection through a mix of specific employer stop-loss deductibles, lowering employer risk both at the member level and overall level. This helps the employer Mind the Gap — shifting risk from the employer to Coefficient.