Respuesta :
A clause is this likely to be (D) Stop-loss provision.
What is the stop-loss provision?
- A limitation on the amount of loss experienced by the insured in a certain period without recompense.
- Stop-loss insurance (sometimes known as excess insurance) is a type of insurance that protects against catastrophic or unforeseeable losses.
- It is purchased by employers who have elected to self-fund their employee benefit plans but do not want to bear full risk for plan losses.
- First, based on the employer's history, the stop-loss carrier calculates the average expected monthly claims PEPM.
- This amount is then multiplied by a percentage ranging from 110 to 150 percent.
- The computed amount is then multiplied by the monthly enrolment to determine the aggregate deductible.
Therefore, according to the above-given situation of Sophie Bennett, a clause is this likely to be a (D) Stop-loss provision.
Know more about the Stop-loss provision here:
https://brainly.com/question/16889922
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Complete question:
Sophie Bennett has personally paid a total of $5,000 in medical costs this year. At this point, there is a clause in her insurance contract that requires her insurance company to pay 100% of her medical costs for the remainder of the year. What clause is this likely to be?
A) Coordination of benefits
B) Hospital indemnity clause
C) Coinsurance
D) Stop-loss provision
E) Major medical expense provision
