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Nearly 250 self-insured U.S. group health plans are seeing their average stop-loss coverage rise by 9.8% in 2022. This is according to Segal’s national medical stop-loss database of 2022 data. It’s an 8% increase from the 2021 data set.
Over the last two years, high-cost claimants with $100,000 or more in paid annual claims account for less than 1% of all claimants but 28% of total health plan claim expenses. Also, there’s an increasing number of drug therapies that exceed $1 million annually in prescription paid claims for a single person. These numbers underscore the value provided by stop-loss policies. Stop-loss coverage can provide asset protection and cost predictability, especially as the number and value of high claims continue to grow. This can be especially helpful to those smaller groups and those with modest cash reserves.
With the rapid rate of change in newly approved medical technology and procedures, employers need to ensure their stop-loss coverage policies align with their coverage needs. Download the bulletin for more details.