Navigate today’s most pressing health industry challenges with a leading global expert by your side.
Discover intelligent digital solutions to help improve outcomes, manage costs, and solve the toughest healthcare challenges.
Meet growing needs for innovative insurance solutions while increasing operational health and improving compliance.
Property & casualty advisory services
Modern flood insurance program
Investment, advisory & trading services
Financial modeling & industrialization
Insurance risk assessment
Geographic rating insights
Premium comparison platform
Retirement & Benefits
Deliver on the promises of the past and create smart solutions for the future.
Pension administration & communication
Retirement benefits administration platform
Compensations & benefits
Benefit plan evaluation
Health & welfare benefits administration platform
Manage complex risks using data-driven insights, advanced approaches, and deep industry experience.
Auto policy underwriting
Software performance enhancement
Mortgage platform for investments & reinsurance
Solvency II reporting & compliance
This is a place where your ideas and insights make an impact. Where an independent, entrepreneurial spirit is an advantage. And where diversity of thought and experience makes us who we are.
Data-driven insight. Deep expertise. Transformative innovation. Since 1947, Milliman has delivered intelligent solutions to improve health and financial security.
Milliman has extensive experience helping providers manage risk through stop loss coverage. Self-funded employers have purchased stop loss coverage for many years. In today’s environment, more and more providers are finding they also need to consider stop loss coverage.
As there is a shift from fee-for-service reimbursements to value-based contracts, the insurance risk is passed on to providers—and providers are responsible for meeting costs targets. There is the potential for significant lost revenue if cost targets aren’t met. Providers may not be able to effectively manage and avoid costs from high risk members, and circumstances outside a provider’s control may drive total costs higher than anticipated.
Milliman can advise your company on which coverage best suits your needs:
Stop loss may be helpful in meeting risk requirements in those states that require actuarial certifications for providers taking risk. In addition, the Centers for Medicare and Medicaid Services may require providers with Medicare Advantage risk contracts to obtain stop loss coverage.
Providers need to be realistic about and understand the variance of outcomes, and Milliman has tools to help providers gain this understanding. Pricing may vary widely year to year or carrier to carrier and is heavily dependent on underwriting judgment. Comparing rates may not always be easy. Milliman has a pricing tool, ExPrT, which can assist in price comparisons.
Ask the tough questions. We’re ready for them.