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Health Care Reform and the Advent of Unlimited Lifetime Maximums: ISCEBS/Aegis Risk Survey Findings (PDF)

2 pages. Excerpt: This year's survey was completed in the wake of health care reform and its removal of individual lifetime maximums - which significantly alters the underlying risk covered by medical stop loss. Although stop loss is not mandated to offer unlimited coverage, the risk is created, and according to this year's survey, 79% of respondents intend to review its coverage - with 44% of those stating its requirement.

Aegis Risk Medical Stop-Loss Premium Survey (PDF)

"Excluding claimants at renewal, known as lasering, is not permitted for 61% of respondents -- with 43% of those having a renewal rate cap.... Plan mirroring is more common, now at 49%.... 98% of surveyed plans cover pharmacy, an ongoing increase from around 90% several years back. Increased high-dollar pharmacy exposure is driving the change, and stop-loss without pharmacy coverage is now ill- conceived."

Medical Stop-Loss Premium Survey (PDF)

"The occurrence of truly catastrophic claimants -- in excess of $1 million -- is further verified with 31% of respondents reporting such a claimant in the last two policy years. Stop-loss remains the primary focus of risk management, with 71% of respondents sharing no interest in alternate approaches. Additional updates are provided on individual stop-loss deductible by employer size and other coverage provisions, including aggregate stop-loss. The primary focus of the survey remains current premium rates ... Stop-loss premium reflecting over 940,000 covered employees is measured."

Medical Stop-Loss Premium Survey (PDF)

"The rising frequency of truly catastrophic claimants continues -- with one in five respondents reporting a claimant in excess of $1 million over the last two policy years. Stop-loss remains the primary focus of risk management, with interest in captives and private exchanges remaining slight at 10% or less amongst respondents.... The primary focus of the survey remains current premium rates ... Stop-loss premium reflecting over 550,000 covered employees is measured."

2016 Medical Stop-Loss Premium Survey (PDF)

"This year's survey ... reflects the ongoing rise in stop-loss premiums and a continued commitment to employer-sponsored, self-funded health plans. The occurrence of truly catastrophic claimants -- in excess of $1 million -- is further verified with over 18% of respondents reporting such a claimant in the last two policy years. Stop loss remains the primary focus of risk management, with interest in private exchanges nearly disappearing at 1% amongst respondents. Captive arrangements show increased interest, but still slight at 14%."

2023 Medical Stop-Loss Premium Survey (PDF)

"[This annual survey] measures the ongoing expense and coverage of medical stop-loss amongst employer-sponsored, self-funded health plans. Recent pricing and renewal requests are further detailed with annualized increases ranging from 6.9% at a $100,000 deductible to higher, more leveraged increases of 15.9% at $500,000. The primary focus of the survey remains current premium rates ... Stop-loss premium reflecting nearly 850,000 covered employees for a total of $727 million in annual premium expense is measured."

2021 Medical Stop-Loss Premium Survey (PDF)

"The occurrence of catastrophic claimants in excess of $1 million is further verified with 29% of respondents reporting such a claimant in the last two policy years.... The primary focus of the survey remains current premium rates, as shown in [several] graphs and tables."

2013 Medical Stop-Loss Premium Survey (PDF)

"Indexing [individual stop loss (ISL)] to underlying trend is a recommended strategy to avoid the impact of leveraged trend renewal rate increases. However, when surveyed, only 7% indicate a definitive plan to pursue that strategy. Almost half (49%) will review a range and make a determination. The rest prefer to keep at the current levels.... [R]eflecting the impact of health care reform, unlimited lifetime maximums are commonplace, reported by 97% -- a significant increase from just 13% in 2010. For the 50% of respondents reporting an interim annual limit, amounts at $2 million to $5 million are the most prevalent."