Physicians Insurance, A Mutual Company
The premier provider of medical professional liability insurance
for physicians and clinics in Washington, Oregon, and Idaho.

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Highlights
Stop-Loss
The Physicians Insurance Stop-Loss Program has provided top-quality stop-loss insurance to the provider and medical clinic communities in Washington and Oregon since 1997. As our longtime policyholders know, we provide not only first-rate provider excess, and medical stop-loss coverage, but also excellent customer service, flexibility, and value. We work closely with you to help you get the best possible coverage at a reasonable price. Moreover, we design your coverage to fit your specific needs. The Stop-Loss Program protects your provider organization or medical clinic from catastrophic patient losses.

Our claims service is unsurpassed. Physicians Insurance processes all stop-loss claims, providing same-person service and exceptionally fast claim turnaround. O
ur claims staff is highly experienced with Medicare, Medicaid, and commercial fee schedules. Additionally, our claims process is enhanced by the use of the SLP program, a specialized software package developed locally to fit our policyholders’ unique needs. Our stop-loss experts use the SLP program to accurately process stop-loss claims, explanation of benefits, and premiums, giving our policyholders the detailed, personalized service they have come to expect from Physicians Insurance.

Provider Excess

The Physicians Insurance Stop-Loss Program has insured capitated provider organizations since 1997. As our policyholders know, we consistently give medical provider organizations greater value with their provider excess coverage. With each capitated agreement, we work closely with you to help you get the best possible coverage at a reasonable price. Just as important, we design your provider excess coverage to fit your specific needs. Whether it's a single capitated contract or multiple contracts to be covered under one policy, the Stop-Loss Program protects the provider organization or medical clinic from catastrophic patient losses.

Medical Stop-Loss


In our Physicians Insurance mission, we pledge “to provide insurance coverage to health care providers at the lowest possible cost consistent with sound financial and insurance practices.” Our dedication to physicians, staff members, and clinics remains strong. In 2002, with medical costs rising in both Washington and Oregon, Physicians Insurance began offering medical stop-loss to provide security and excellent service to medical groups choosing to self-fund their medical benefits. 

Our first-rate medical stop-loss coverage—both specific and aggregate—enables medical-related employers to experience the many benefits of self-funding. With Physicians Insurance medical stop-loss coverage, you can

 Lock in rates as early as 120 days in advance of policy effective date.

  • Choose from a full range of contract claims bases: 12/12, 12/15, 12/18, 12/24, 15/12, 24/12, and PAID.
  • Choose from a full range of specific deductible levels: $25,000 on up to $250,000. 
  • Set up a specific split-funded premium arrangement. This option may enable the policyholder to reduce specific PEPM rates by taking on additional specific liability.
  • Establish simultaneous funding on specific reimbursement. This value-added service allows policyholders the option to submit a specific claim for reimbursement at the time high-cost member claims are paid.
  • Implement Aggregate Monthly Deductible Advance Reimbursement (MDAR). This allows policyholders the option to submit an aggregate claim for reimbursement during the policy year instead of waiting for policy year-end. 

New Options as of September 2007:

  • Contract Advantage Plan (CAP). This allows policyholders the ability to accurately forecast a maximum renewal increase for their specific coverage when renewed with Physicians Insurance. CAP coverage also helps to guarantee no new lasers at renewal.
  • Specific and Aggregate Terminal Liability Coverage (TLO). This option is designed for first-year self-funded employers. TLO allows policyholders three additional claims-paid months when they choose to go back to a fully-insured plan.

Upcoming enhancements:

  • 12 for 10 product option. This unique product, designed for first-year self-funded policyholders, allows policyholders to pay only 10 months of premium for a 12-month policy. The second and third months are a premium holiday.

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For more information about our Stop-Loss Program, please contact us today at 1-800-962-1399 or stoploss@phyins.com.

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