Frequently Asked Questions

Explore our list of common questions and answers about our stop-loss insurance supplement.

When is the Benefit Period?

The benefit period for supplemental stop-loss coverage is January 1st through December 31st. Self-insured employers may elect to join at any point during the year. There is no retro-payment required and no benefit for any period prior to enrollment.

How Does Coverage Work?

Participation in the Captive requires prescription benefit coverage through RxBenefits, the adoption of RxBenefits’ Protect™, Specialty Pharmacy coverage and Specialty fulfillment through an approved pharmacy.

New hires with pre-existing conditions AND members who are newly diagnosed are eligible for supplement stop-loss coverage. Once an eligible member reaches the plan’s deductible, the plan is entitled to reimbursement of qualified expenses up to the limits of the policy—$1,000,000 annually; $3,000,000 lifetime.

Employers that remain continuously enrolled will continue to receive benefits in subsequent years for those members that are new to the plan or newly diagnosed after the initial enrollment date, up to the limits of the policy.

Is This an RxBenefits Product?

RxPharmacy Assurance is a wholly owned subsidiary of RxBenefits; however, it is a separate entity licensed to operate within the State of Vermont in conjunction with Marsh Captive Management.

What Does Supplemental Prescription Stop-Loss Cover?

Our supplemental stop-loss coverage applies to specialty prescription therapies that are used to treat a broad and comprehensive range of conditions.

What is the Cost in 2023?

There is a one-time fee for the self-insured employer to enroll in the Captive. Premiums are affordably priced, particularly when compared to traditional stop-loss; and, will be based on attachment point, as well as average member count. Premiums will be billed on the 1st of each month. Continuous coverage is based on payment of the established premium.

How Do I Get Started?

Interested insurance brokers can request broker certification information via the RxPharmacy Assurance website. Contact us by filling out the form below.

Pharmacy Risk

RxPharmacy Assurance can help self-funded clients remain self-funded and aligned with their goals for choosing to self-fund in the first place: controlling healthcare costs while protecting the health and safety of their members.

Request a quote today, or schedule a consultation to learn more about offering the stability and security of RxPharmacy Assurance to your clients.

463 Mountain View Drive
Suite 301
Colchester, Vermont 05446

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