The stop-loss has also been called out of pocket or calendar year maximum. It means how much the client has to pay out of pocket before the insurance company pays 100%. The rate relies on if your deductible is exclusive or inclusive. Inclusive means your co-insurance of 60/40. 70/30 or 80/20 starts your payment of the lower percentage of the split. Exclusive you have a deductible amount to exhaust, then you begin to pay the co-insurance split amount until you reach the max of that amount, the stop-loss is the deductible plus the split amount.