Aetna afa medical and stop loss employee enrollment change form: Fill out & sign online

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What is a medical stop-loss claim?

What is Stop-Loss Insurance? Stop-loss insurance is designed for employers who self-fund their health benefit plans for their employees but want to hedge against the risk of assuming 100% liability for losses that stem from catastrophic claims.

What is a stop-loss fee?

Stop-loss insurance comes in two varieties, specific and aggregate. Specific stop-loss insurance reimburses a self-funded group for a large claim from one individual. Aggregate stop-loss insurance reimburses a group when the plan's overall costs rise above a certain figure, usually 125 percent of expected claims.

What is Aetna's claim filing deadline?

Timely Filing Requirements of Claims New claims must be submitted within 180 calendar days from the date of service. Claims will deny if not received within the required time frames. Corrected claims must be submitted within 365 days from the date of service.

What is individual stop-loss?

Individual Stop Loss (ISL) is a stop loss policy written in conjunction with a self-funded medical plan, limiting the employer's liability on each individual to a set dollar amount per policy year.

What is a Cigna ASO plan?

\u2013 Employers with self-funded plans, also called Administrative Services Only (ASO) plans, often purchase stop-loss coverage to protect against catastrophic costs.

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