Aggregate stop loss and specific stop loss are kind of like rain boots and umbrellas. They work in slightly different ways to address the same problem. You can choose to use both types or just one depending on what kind of protection you need, both using both is the best way to limit your exposure in a storm. Continue Reading >
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 >
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 >
While none of us could have exactly predicted the COVID-19 pandemic, the stop-loss industry is nothing if not prepared for emergencies. We know that a lot of self-funded employers are scrambling right now to figure out what happens next. Stop-loss carriers have mobilized to increase flexibility that allows policyholders to maintain coverage, and to make sure that policyholders have all the resources they need to weather this storm. Here are answers to some of the most common questions we’re hearing right now. Continue Reading >
When was the last time you scrolled through the health and fitness apps available on your favorite device? Maybe you’ll check them all out the next time you have, oh, five or six free days in a row. That’s probably about how long it would take you to review the full range of health apps available in your device’s app store. Continue Reading >
Saving money is the primary reason that many employers decide to provide self-funded insurance. Balancing that objective and the healthcare needs of employees can be an ongoing struggle. Trimming benefits would help you cut spending, but not without sacrificing employee health and morale. Instead, think about making some strategic shifts to your plan. For some employers, it only takes a few small changes to dramatically slash healthcare spending. Continue Reading >
How can you make this upcoming year the best one yet for your business? It’s a lofty goal, but an achievable one too – that is, if your employees are ready to give you their best work this year. Launching a workplace wellness program is one way to motivate them to do just that. Continue Reading >
As we head into a new flu season, self-funded employers have good reason to be concerned about healthcare costs. Let’s face it, the flu is bad news for everyone. The best case scenario involves a healthy adult getting a mild case, spending a week feeling miserable and maybe making a single trip to the doctor. But others aren’t as lucky. Continue Reading >
There’s a lot of jargon to keep straight around the topics of self-funded insurance and stop-loss insurance. TPAs, attachment points, ISL vs ASL, catastrophic thresholds, lasers – were other people learning this language while you were sitting in high-school Spanish class? Continue Reading >
At the start of this century, artificial intelligence was the stuff of sci-fi movies, not a recognizable part of the average person’s life. What a difference a few decades makes: Although we’re hardly living in a real-life version of “Minority Report,” AI technology is now all around us. Continue Reading >
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.
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