Stop-loss restructure eliminates $290K laser and restores plan predictability
Case study by Corry Hull, REBC®, CSFS®
$290K
Laser eliminated at renewal
11
Stop-loss carriers quoted
3
Carriers offering no-laser coverage
$100K
Specific deductible maintained
The Challenge
A 210-life manufacturer had a $290,000 laser on a high-cost claimant at renewal — effectively removing stop-loss protection for their highest-risk member. Their incumbent carrier offered no alternatives. The CFO was considering returning to fully-insured.
The Approach
We competitively bid stop-loss across 11 carriers with full disclosure of the lasered claimant's diagnosis and projected costs. Three carriers offered coverage without a laser at competitive rates. The selected carrier provided specific coverage at $100,000 with no laser and a terminal liability provision. The plan remained self-funded.
Note: This case study is a composite of multiple employer engagements. Identifying details have been changed. The lasered claimant's condition is described in general terms only. Sources: Stop-loss carrier quote documentation; incumbent renewal terms; claims projections from TPA.
Methodology & Verification▾
Baseline
Incumbent stop-loss renewal with $290,000 laser on identified high-cost claimant.
Intervention
Competitive stop-loss RFP with full claimant disclosure; selected carrier with no laser at $100,000 specific.
Measurement period
Renewal plan year.
Savings methodology
Risk transfer value = projected claimant costs above specific deductible that would have been unprotected under lasered contract.
What was excluded
Broker compensation and administrative costs excluded.
Employer size
210 benefit-eligible employees; ~175 enrolled in medical.
Funding type
Self-funded with specific and aggregate stop-loss.
Source / verification
Quote documentation from all 11 carriers; final policy terms verified against executed contract.