Aegis Risk - Infusing Risk Management into Benefits Management

Submission to the 2008 Aegis Risk Medical Stop Loss Premium Survey has closed. However, you may still respond and receive a FREE copy of the Survey results. You will also be included in requests for next year's Survey. Respond below.

This is the only employer-based survey focused exclusively on stop loss premiums.

Survey Submission
Complete the below form and submit electronically. Your contract's schedule of benefits, as well as current enrollment and premium rates, will provide all the needed information.

Please note your corporate firewall protection may prevent the submission of internet forms. If so, please complete then highlight the entire survey box upon completion, copy, and paste into an email to info@aegisrisk.com. Or, you may screen print and fax a completed survey to 703-548-4399.

Please provide data on 2008 stop loss premiums. All submissions are confidential and survey results will not reveal respondent-specific data.

Submit Survey

Press 'Tab' to advance to the next field - do not press Enter. For further information on the requested data, roll your cursor over the entry box. Press 'Submit' when finished. A successful submission will return you to our Home Page. In the event of an error, please submit as described above. Thank you.

Respondent Information
Organization:
Contact name:
Contact phone number:
Contact email:
Mailing address:
Individual Stop Loss (ISL)
Deductible:
Contract type:
Monthly rate ($), Single:
Monthly rate ($), Family / Composite:
Enrollment, Single:
Enrollment, Family / Composite:
Covered services (check all that apply)	Medical
	Pharmacy
Individual lifetime maximum ($):
Size of aggregating deductible, if any:
Carrier / Underwriter:
Aggregate Stop Loss (ASL)
Does your plan have ASL coverage?	Yes
	No
If yes, what corridor?:
Monthly rate ($), Composite:
Enrollment, Composite:
Additional survey/coverage comments (please provide):