Census for stop loss insurance

The generic definition of a census is “an official count or survey of a population, typically recording various details of individuals.” When it comes to a health insurance census used for stop-loss insurance, carriers typically want to see a list of the covered individuals’ gender, zip code, marital status, and date of birth. This list can be anonymous; names do not need to be included.

Stop loss insurance carriers use census information, along with other information collected such as plan description, list of high cost claims over 50% of your specific deductible, with diagnosis and prognosis information, current stop loss coverage information including current deductible, terms and rates, to determine their quote for your organization’s annual fee.

Census information is a driver for your organization’s stop loss insurance rates. A younger group overall is presumed to be healthier and use the health care system less frequently. Therefore, the perceived risk to a stop loss carrier is lower and your stop loss rates could be lower.

Where do you get a census for your organization? You may be able to run a report from your payroll software. Otherwise, your HR team may need to assemble this data. Since you will need it annually for your renewal, consider putting a system in place to keep this information up to date.