Physicians Insurance
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Medical Stop-Loss

The Stop-Loss Program protects your provider organization, medical clinic, or health plan from catastrophic patient losses. For more than 15 years, the Physicians Insurance Stop-Loss Program has provided top-quality stop-loss insurance to provider organizations and medical clinics.

Our first-rate medical stop-loss coverage—both specific and aggregate—enables medical-related employers to experience the many benefits of self-funding. With Physicians Insurance medical stop-loss coverage, you can:
  • Choose from a full range of contract claims bases: 12/12, 12/15, 12/18, 12/24, 15/12, 24/12, and PAID.
  • Lock in rates as early as 120 days in advance of policy effective date.
  • Choose from a full range of specific deductible levels: $25,000 on up to $250,000.
  • Include an Aggregating Specific Deductible Endorsement. This option may enable the policyholder to reduce specific PEPM rates by taking on additional specific liability.
  • Establish simultaneous funding on specific reimbursement. This value-added service allows policyholders the option to submit a specific claim for reimbursement at the time high-cost member claims are paid.
  • Include a Monthly Aggregate Deductible Accommodation (MADA) Endorsement. This allows policyholders the option to submit an aggregate claim for reimbursement during the policy year instead of waiting for policy year-end.
For more information about medical-stop-loss coverage, please contact Nancy Emitu today at 1-800-962-1399, extension 6531, or
Forms Care Management
Care management and cost containment are crucial in the management of health care in today’s changing medical landscape. The Physicians Insurance Stop-Loss Program is here to help. Aside from the value-added care management team that can assist with complex and high-cost cases, we also recommend select specialty providers and transplant networks to help you to provide the best care with the best outcomes at the best overall cost.

For more information about our contracted transplant networks, please visit their Web sites at the links below:

Website LifeTrac
Website OptumHealth (URN)

NOTE: These brief descriptions do not offer or change coverage. All insurance policies are controlled by the terms of the policies.
pile of medical records wtih stethascope hanging on it

Our claims service is unsurpassed.

Physicians Insurance processes all stop-loss claims, providing same-person service and exceptionally fast claim turnaround.

Our claims staff is highly experienced with Medicare, Medicaid, and commercial fee schedules.

Additionally, our claims process is enhanced by the use of the SLP program, a specialized software package developed to fit our policyholders’ unique needs, to give the detailed, personalized service policyholders have come to expect from Physicians Insurance.

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