Demystifying Stop-Loss: Strategies to Manage Rising High-Cost Claims

High-cost claims are on the rise, and with them, plan sponsors are seeing annual stop-loss premium increases in the double digits. For self-funded employers, it may seem like there’s not much that can be done to mitigate these costs, but many purchasers don’t fully understand the many complex factors that go into a stop-loss quote and how to determine the appropriate level of coverage for their organization. Are the specific and aggregate attachment points optimized for the plan? Are there instances where lasers are actually cost effective for a plan? Is additional run-out worth the added cost? Should you be considering additional stop-loss policies for areas like gene and cell therapy?

For this member meeting we’ll be joined by one of the leading stop-loss experts in the country, Jon Camire, Managing Director at Blackstone and Chief Financial and Analytics Officer at Equity Healthcare, to talk about all the nuances and best practices that go into stop loss coverage. Jon will lay out the host of considerations that plan sponsors should be taking into account as they evaluate their coverage options, and he will help equip attendees with the knowledge they need to manage their spend effectively. This presentation will help any employer who is currently self-funding or that thinks they may want to self-fund in the future.

About Jon Camire, FSA, MAAA

As the Managing Director at Blackstone and Chief Financial and Analytics Officer at Equity Healthcare, Jon Camire is responsible for financial evaluation, benchmarking, and modeling of health plan performance optimization for existing and potential Blackstone Equity Healthcare Member Companies, including benefit design alternatives, clinical programming, and innovation partner opportunities.

Prior to joining Blackstone Equity Healthcare, Jon served as Vice President of Financial Modeling with Unum, spearheading the modernization of the actuarial and financial management capabilities across the enterprise. Prior to Unum, Jon operated his own health actuarial and healthcare reform consulting practice supporting payer, provider, employer, and government clients in navigating the risks and opportunities of rapidly evolving health system dynamics. Earlier in his career, he held actuarial leadership roles with Blue Cross Blue Shield of Massachusetts, driving employer informatics, Commercial product development, Medicare Advantage and Stop Loss. Jon holds a B.S. in Mathematics from the University of Massachusetts. He is a Fellow of the Society of Actuaries and a Member of the American Academy of Actuaries.

SHRM professional development credits available.

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