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Employer Benefits IQ
Risk

Stop-Loss Lasers Explained

A laser is a carrier-imposed higher specific deductible on a known high-cost individual. If a member has a chronic condition, an upcoming transplant, or a known high-cost treatment, the stop-loss carrier may "laser" that person — meaning you bear more risk for their claims than for other members.

How lasers work

Your standard specific deductible might be $100,000. A laser on a member with a known transplant might set their individual deductible at $300,000 or even unlimited. The carrier is essentially excluding that person's catastrophic claims from coverage above the laser amount.

Lasers are most common at renewal, when the carrier reviews your claims experience and identifies high-risk members. A member who had a $500,000 claim last year is a prime laser candidate at renewal.

How to negotiate laser protection

Laser cap
Negotiate a maximum laser amount — e.g., no laser above $300,000 regardless of the member's condition.
No-new-laser guarantee
Carrier agrees not to add new lasers at renewal for members already on the plan at inception.
Laser-free contract
Some carriers offer laser-free contracts at a higher premium. Worth considering for groups with known high-risk members.
Laser buydown
Pay an additional premium to reduce or eliminate a specific laser on a known high-cost member.