Stop Loss Coverage

Johnson County is seeking a vendor to provide stop loss coverage for its self-insured medical and prescription drug plans. The selected vendor will be expected to provide exceptional customer service, statutory and regulatory compliance, and monthly participation and status reports. The contract will be for a one-year period beginning January 1, 2026, with an option to renew for an additional year. The vendor must have an AM Best rating of A- or better, a history of financial stability, and the ability to provide timely stop loss reimbursements. The vendor will be responsible for maintaining a stop loss claims database, acquiring and processing stop loss reimbursement claims, and notifying the County of any amendments or changes to the policy. Key requirements include: • Guaranteed claim reimbursement of two weeks or less when all necessary claims documentation is submitted • Ability to offer an expedited claim capability rider • A.M Best rating of A- or better • Guarantee a "Paid" contract for ISL and ASL if the County renews with the vendor in 2027 • Guarantee a maximum rate increase cap of no more than 40% for the next renewal