How Medical Stop Loss Insurance Protects Against Most Prominent Catastrophic Claims

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If you currently have stop loss underwriting services, or are in the market to obtain some, you probably have a good idea about how catastrophic claims can be a huge blow to your company’s cash flow. What you might not know is that there are typically ten catastrophic claim conditions that account for more than half of the total reimbursements paid out. What are these conditions, can they be prevented, and how can risk management healthcare help protect your business?

A recent in-depth study conducted by Sun Life Financial showed that only ten catastrophic conditions account for 52.8% of all catastrophic claim conditions, amounting to over a billion dollars in medical stop-loss claims reimbursements. The total claim reimbursement amount of each catastrophic condition may surprise you. In order, the highest catastrophic claim conditions were:

  1. Septicemia – $986,023,854
  2. Malignant Cancer – $367,880,466
  3. Leukemia – $168,724,691
  4. Chronic Renal Disease – $162,451,305
  5. Congenital Anomalies – $88,950,652
  6. Premature Births – $67,474,522
  7. Congestive Heart Failure – $53,360,418
  8. Cerebrovascular Disease – $52,220,511
  9. Respiratory Failure – $48,560,851
  10. Complications of Surgical and Medical Care – $47,927,582

All of the other conditions represented in the study only accounted for 47.2% of other stop loss reimbursements paid, which were equal to $986 million.

Prevent Disaster and Protect Your Business

These figures are rather surprising, especially when you factor in that some of them are preventable conditions. Nobody wants to be sick, and a good employer wants his or her employees to be healthy. A healthy employee tends to translate into peak productivity. There are some steps that employers take to help ensure the optimal health and wellbeing of the people that make up their workplace: such as a tobacco-free environment, free gym memberships based on high performance, and company outings like cancer relays and softball games. While you can take all of the best precautions in the world, catastrophes are sometimes simply unavoidable. This is where a stop-loss policy comes into play. Stop loss underwriting services offer your business a safeguard, ensuring that you won’t have to pay out of pocket for these catastrophic claims.

Word-Class Level Funded Health Plans

You are a forward-thinking and proactive business owner, and you care for your employees. When you incorporate medical stop-loss insurance, you get peace of mind for your business and also utilize forecast technologies to predict future spending and budgets. At Prodigy, we engage clients to try and help to reduce the amount of catastrophic claims conditions in the future. We offer stop loss underwriting services that are unmatched. As independent underwriters aren’t bound by the corporate policies of many direct providers. You will never see any kind of hidden fees or hard-to-understand insurance industry jargon on any of our policies. We also outsource our claims department to add another layer of protection for your business with a stop loss insurance plan. If you would like to speak with one of our representatives about a specific healthcare underwriter question, or to set up a policy, contact us today.

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