The Effect of Preterm Infants on Stop Loss Insurance

A pregnant woman is considered “full term” at 37 weeks even though most natural births occur around week 40.  Preterm infants are born before 37 weeks.  Extremely preterm babies require medical intervention and hospital stays for weeks before going home with their parents.  Premature births are only 1.3% of claimants but represent over $67 million in paid stop-loss claims.  The cost of a premature birth with complications is 12 times higher than that of a normal full term birth; $55,393 for a preterm birth  compared to $5,085 for a normal full term birth in 2009 (1). Trends in preterm infant care Million Dollar Babies The Impact of Multiples Stop Loss and Preterm Infants Continue Reading >

How Cyber Secure is Your Self Funded Plan?

Self-Funded Insurance plans are not immune from the many data breaches that have been occurring in the last several years. Not only has the number of breaches increased, but the level of sophistication used by hackers to steal date has also increased. Preventing a breach requires diligence but the alternative can be detrimental to an organization. Continue Reading >

The Value of Self Funding

Read the The Value of Self Funding PDF created by the Self-Insurance Educational Foundation, Inc. (SIEF), a 501(c)(3) non-profit organization affiliated with the Self-Insurance Institute of America, Inc. (SIIA). The foundation’s mission is to raise the awareness and understanding of self-insurance among the business community, policy-makers, consumers, the media and other interested parties. Continue Reading >

Self -Insured Protection Act SIPA Introduced in Congress to protect Self-Funded Health Insurance Plans

In the past few years, there has been legislation introduced in several states that has called for new rules that impose limits on self-funded insurance plans and the stop loss insurance that they buy. There is a fear that these self-funded plans will appeal to companies with healthier workers and, as a result, drive up premiums for businesses that remain in typical plans. Continue Reading >

Insights

Contact Block (Blog)

Recent Comments

    Newsletter Signup

    Signup to start receiving the latest newsletters from StopLoss right to your email.
    Stay up to date on insurance trends and insights.

    Back to Top

    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.