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PARTIAL SELF FUNDINGAND MEDICAL PLAN COSTTERMS <br />PARTIAL PLAN SELF FUNDING–A medical plan that uses Stop Loss Reinsurance to provide <br />coverage for Specific and Aggregate Claims <br />STOP LOSS REINSURANCE–Insurance coverage provided to Self-Funded plans to cover risk <br />above a Specific Claim amount and on an Aggregate Claim basis. <br />SPECIFIC DEDUCTIBLE–The amount of claims paid before the Specific Stop Loss reinsurance <br />takes effect.The City carries a policy with a Specific deductible of $165,000 per covered <br />claimant. <br />AGGREGATE DEDUCTIBLE-The amount of claims paid before the Aggregate Stop Loss <br />reinsurance takes effect.The Aggregate Deductible is determined based on a claim factor and a <br />risk corridor of usually 125%, after which the Aggregate insurance takes effect. <br />PER CAPITA COST–The cost stated as an annual amount based onthe number of employees <br />participating in the plan. <br />COVERED MEMBERS–This is the total number of participants in the plan including employees <br />and dependents. <br /> <br />