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Cancer, Other Catastrophic Claims Account for Half of Stop-loss Reimbursements


  10:25:00 pm, by MedBen5   , 260 words,  
Categories: News, Health Plan Management, Stop-loss, Cost savings, Research

Cancer, Other Catastrophic Claims Account for Half of Stop-loss Reimbursements

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Over half of all stop-loss reimbursements can be traced to a mere ten ailments, finds a new study that highlights the importance of stop-loss coverage for self-funded employers. MedBen is here to help groups with stop-loss carrier advice and cost control strategies.

Benefits Pro reports that, between 2012 and 2015, self-insured employers covered by Sun Life stop-loss insurance paid out 53% of stop-loss claims reimbursements for just ten catastrophic claim conditions. Of these, various forms of cancer made up 26.6% of reimbursements, due in part to new treatments and high-cost medications.

For self-funded employers, numbers like these serve as a stark reminder to have a stop-loss carrier that not only serves as a safety net for catastrophic claims, but balances quality coverage with cost considerations. Toward this goal, MedBen shops multiple carriers to ensure that clients retain the desired level of specific and aggregate protection, and negotiates the best possible rates.

Moreover, while stop-loss insurance helps to limit potential losses, MedBen reduces client risk even further. Our cost containment solutions range from advanced claims management to plan language expertise for specific catastrophic conditions, including chronic renal disease (ranked #3 in the Top Ten) and transplants (#6).

Learn more about MedBen stop-loss services and savings solutions by contacting Vice President of Sales & Marketing Brian Fargus at

The complete Top Ten:

  1. Malignant neoplasm: $429 million in reimbursements between 2012 and 2015 (18.5% of all stop-loss claim reimbursements during that period)
  2. Leukemia/lymphoma/multiple myeloma: $188 million (8.1%)
  3. Chronic renal disease: $156 million (6.7%)
  4. Congenital anomalies: $96.3 million (4.1%)
  5. Premature births/low birth weight: $75 million (3.2%)
  6. Transplants: $62.2 million (2.6%)
  7. Congestive heart failure: $57.8 million (2.5%)
  8. Cerebrovascular disease (stroke): $57.4 million (2.4%)
  9. Respiratory failure: $55 million (2.3%)
  10. Septicemia: $54.7 million (2.3%)

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