SA Benefit Services Stop Loss Services

We are known in the stop loss industry for our turn-key process providing you with a “Single Source Solution”.

Stop Loss Services

  • Stop Loss market analysis to assure you are binding the best stop loss options based on the groups experience.
  • Binding the account.
  • Plan document vs Stop Loss Policy review to identify any coverage gaps, appeal if necessary.
  • Coordinate NDA’s from medical administrator, PBM’s and third-party vendors to ensure consistent flow of reporting.
  • Administrator, PBM and Third-Party Vendor Reporting and Claim Filing Interface.
  • Stop Loss monthly reporting and claims management.
  • Servicing the account from daily inquires to appeals.
  • Claim notifications and filings as required by the stop loss carrier.
  • Monthly audit of specific and aggregate reports.
  • Reimbursement payments are sent directly to the group via ACH or check from the stop loss carrier.
  • Monthly invoice flexibility with monthly invoicing by SABS or self-billing by the group.
  • Monthly or Quarterly reporting package integrating medical, prescription and/or third-party vendors to track aggregate and specific stop loss data received and claims filed on one report.
  • SABS utilizes a software matrix to communicate underwriting Request for Proposals, claim notices and specific claims with stop loss carrier’s. The Exchange Centre utilized, along with the software, results in quicker turnaround times with assurances that all data is encrypted, and password protected in compliance with HIPAA and EPHI privacy requirements.
  • Renewal Market Analysis is simplified when SABS manages the stop loss during the plan year by providing our “SIMPLE RENEWAL”.
  • Ability to manually underwrite a case illustratively to successfully negotiate with our stop loss carriers.

To learn more about our “Single Source Solution” please contact us at 210.996.2190 or email us.