Stand Alone Rx Aggregate Stop Loss

If Rx standalone Stop Loss premium = 2-3% of overall Rx spend and the savings on medical stop loss premium is 5%-10% when carving out the Rx program, what is the net difference?

Here is an example of a small 350 life case we picked at random assuming maximum stop loss discount on medical (10%) and maximum savings on Rx (3%):

.10 X $180,000 (SL) – .03 X $350,000 (Rx) = net annual premium savings of $7,500 for a savings of $1.79 pepm.

Seems like a whole lot of work for a small amount of money in this instance. Try this exercise on your book of business and see if it makes sense for your clients.


RxReins is a dedicated Managing General Underwriter (MGU) that specializes in prescription drug stop loss insurance. RxReins helps employers minimize their risk associated  with self-funding their prescription group benefit plans. Let’s face it, with major healthcare reform, today there is more reason than ever for employers to secure protection. Costs are rising and benefits can represent risk. That’s where RxReins comes in.

Our business sounds highly specialized, and that is for a good reason. It is precisely that, prescription drug benefits are our area of expertise. Being that we are a niche boutique firm, we are able to provide personalized service.  We are readily accessible, knowledgeable and committed to developing an alliance between health care demands, employee benefits and employers’ success. We value every trusted relationship and are dedicated to education, support and innovative solutions.

With the growing trend toward self-funding, our products are increasingly invaluable. Whether you’re a broker, consultant, pharmacy benefit manager (PBM), or third party administrator (TPA), we customize programs with innovative Rx stop loss solutions that provide security against high claims costs.

As sought-after underwriters, we provide Rx stop loss insurance to companies across the nation, ranging from 50 to 5,000 employees. RxReins also provides stop loss insurance for self-funded dental and vision group benefit plans. In the end, it’s about solutions that cap liability and protect employers from runaway risk. Above all, that means peace of mind.

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