Reports and Surveys | April 22, 2021
This infographic looks at health plans' medical stop-loss coverage for the 2021 policy year.
It analyzes data from 239 plans, with 2,200 covered participants per group on average.
Segal has maintained its National Medical Stop-Loss Database since the ACA eliminated annual and lifetime dollar limits on essential health benefits.
Our latest analysis found that:
As the number and value of high-amount claims continues to grow, stop-loss coverage provides important asset protection and cost predictability, particularly for self-funded plans, smaller groups and those with modest cash reserves.
The rapid rate of change in newly approved medical technology and procedures requires a close inspection of the coverage language offered by each stop-loss insurer. Segal experts carefully review stop-loss contract provisions to make sure policy language aligns with a plan’s coverage needs so sponsors can secure coverage that meets their expectations.
This page is for informational purposes only and does not constitute legal, tax or investment advice. You are encouraged to discuss the issues raised here with your legal, tax and other advisors before determining how the issues apply to your specific situations.
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