All posts by Denise Doyle

Supporting Employee Health and Wellness While Continuing Remote Work

When your employees are unwell, your business is unwell. Supporting employee health is good for morale, good for productivity and really good for your budget. Having a largely healthy workforce is a key element of controlling health care costs, especially for self-insured employers that cover their own medical claims.  Continue Reading >

Woman works from home on a laptop with a red coffee mug. Employee health.

Startups, Self Funding and Stop Loss

For a startup to last beyond a few years, all the stars have to align. The business has to have a great product and a way to reach its customers. There has to be a place for that product in the market. Investors have to be willing to fund the business until it starts earning profits, which may take years. A successful startup also needs a team of skilled employees who are engaged in the work and committed to building something that lasts. Providing high-quality health insurance is one way a growing startup can attain and retain top talent. Self funding and stop loss coverage are two tools that can make that goal achievable. Continue Reading >

Startups

Why Would An Employer Choose Self-Funded Insurance?

When it comes to health insurance, choice is a good thing. American employers are spoiled for choice these days, with a variety of insurance arrangements available to even small businesses. But all that choice necessitates making some tough decisions. Before you can get into the nitty-gritty about benefits and co-pays, first you have to make a big decision. Should your company be fully insured and pay premiums to an insurance company, or should you choose self-funded insurance, sidestepping the insurer and paying employees’ claims yourself? Continue Reading >

self-funded

Preventive Medicine is the Best Medicine

It’s preferable to stop a fire from starting than it is to stop the flames from spreading, or to undo the damage that they cause. Prevention is naturally a primary goal for healthcare providers, who strive to keep patients from becoming sick and/or getting sicker. But self-insured employers benefit from this branch of  healthcare too. Though it’s hard to say definitely if preventive medicine will help you dramatically slash costs, embracing prevention has lasting benefits for all involved. Continue Reading >

preventive medicine

Setting the Record Straight on Self Funding: Forget These Five Myths

How much do you know about self-funding? For many people, the answer is probably “nothing,” but self-funding should be a familiar concept to anyone involved in their company’s decision-making process around health benefits. Unfortunately, this insurance arrangement isn’t well understood by everyone—and that misunderstanding keeps companies from saving money. Continue Reading >

self-funding myths

What Employers with Self-Funded Plans Should Know About High-Value Claims

In a largely unpredictable world, some things are constants. Housing prices and college tuition will rise every year. So will healthcare costs. Each year, more and more Americans incur high-value medical claims in excess of $500,000. For self-insured employers to accurately plan ahead, it’s important to have some idea just how much and how quickly those major claims will rise. Stop Loss Insurance, Inc. has been tracking self-funding trends for our clients for many years. Back in 2014, we broke down data from Highmark, Inc. on high-value claims to help our clients understand the current landscape. Six years later, the numbers have changed but the trends remain the same. Here’s what you need to know. Continue Reading >

high-value claim

COVID-19’s Impact on Self-Insured Employers

Every American business has been touched by the COVID-19 pandemic. If you’re feeling anxious and uncertain about how this unprecedented experience will affect your business’s healthcare spending, you’re in good company. This is an issue that all self-insured employers are grappling with right now. While there’s still plenty that none of us know about the road ahead, we do already know so much more than we did just last month about how COVID-19 will affect self-insured employers. Continue Reading >

covid-19 self-insured employers

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In 2011, the top 5 most expensive medical conditions treated in US hospitals were: Septicemia, Osteoarthritis, Complication of device, implant or graft, Liveborn, and Acute myocardial infarction

From 2010 to 2013, the number of claims that were individually $1 million or above rose by 1,000%

In 2017 approximately 18% of the American public will purchase insurance through exchanges, radically transforming the health insurance landscape.

In 2014, 98% of large firms (= 200 Workers) offer 1+ wellness programs to their employees.

The most costly 1% of patients account for 20% of national health expenditures – accruing average annual expenses of nearly $90,000 per person.

6% of firms offering fully-insured plans report they intend to self-insure because of Obamacare.

In 2014, PPO plans remained the most common plan type, enrolling 58% of covered workers.

In 2012, 93% of businesses with 5,000+ employees and 80% of companies with 1,000-4,999 employees were self-funded

Massachusetts has the third-highest prevalence of self-funded insurance in the small-group market (Fewer than 50 employees).

In 2013, the average deductible was $2,906 for individuals selecting plans from marketplaces. This compares with average deductibles of $1,135 for an individual with employer coverage.

In 2013, the average annual premiums for employer-sponsored health insurance are $5,884 for single coverage and $16,351 for family coverage, up 5% and 4% respectively from 2012.

From 2010 – 2013, cancer followed by chronic/end stage renal disease and leukemia accounted for the top 3 costliest illnesses.