Axene Health Partners, LLC

In an actuarial sense, health care claims be divided into two groups: (a) high-frequency/low-severity, and (b) low-frequency/high-severity (a.k.a., catastrophic claims). The high-frequency/low-severity claims are typically considered to be very stable and predictable across time periods. The low-frequency/high-severity claims, however, are very unstable and unpredictable from year-to-year. The purpose of stop-loss is to protect against the financial impact that arises due to the volatile nature of the low-frequency/high-severity claims from year-to-year. Read the full article to learn more!

Catastrophic Claim Volatility and Stop-Loss Considerations for Self-Funded Plans In response to a prior article I recently authored, Risk-Based Capital Considerations for Self-Funded Plans, I had a request for a follow-up article focused on stop-loss as a risk mitigation strategy. In an actuarial sense, health care claims be divided into two groups: (a) high-frequency/low-severi...