Thank you for this explanation clip. Question please. A. Smith 's claim is $300k. Laser's limit is $250k. Who's on the hook to pay for the difference of $50k? Also, at 5:25, you mentioned that if someone's claim was up to $1M, that would be an exception and carved out. Who carves that that? The employer or the stop loss carrier?
How does a lasered individual apply to the agg deductible? Are the claims from the lasered individual only included in the agg if the exceed the higher deductible threshold?
@@SelfFunded hey Spencer, great series! I did want to comment and let you know that (at least at Partners) only the claims paid up to the group's specific deductible apply to the aggregate stop loss policy. So while the client is still on the hook to pay the claims up to the laser amount, only the claims up to the group's specific deductible apply to the aggregate. The reason for this is if a claimant was given a $1M laser (heaven forbid) you'd have to figure in the extra $900k (if the ISL was $100k) into your attachment point. Your videos are a great way for me to sharpen up on the basics and also make it easier for me to explain to family and friends what I do on a daily basis! Keep it going!
