Introduction to Stop-Loss Coverage

[00:00:00] Stacey Richter: Episode 478. "Stop Loss Coverage, Part 1: How It Goes Right, and How It Can Go Horribly Wrong.” This show is chockfull of advice. Today I speak with Andreas Mang and Jon Camire.

Hey, question for you. Can it ever actually be better for a claim to get lasered? If your knee jerk reaction is, Nope. No, not so much. Lasered claims are always bad. And or if you have no idea what I'm talking about, do continue to listen. This question gets answered. 

To listen to this episode or read the show notes with mentioned links, visit the episode page.

High Cost Claimants and Stop-Loss Coverage

[00:00:55] Stacey Richter: Also, if you are interested in high cost claimants from almost any angle, this show is in fact part of the high-cost claimant run of shows. What you'll learn today is some insights relative to how plan sponsors go about making sure they can pay you. Like if you work for, for example, some clinical organization.  

This run of shows, by the way, about high cost-claimants, includes episode 471 with Christine Hale, which spills over into the Eric Bricker episode 472, about high-cost claimants, mostly from the hospital point of view. 

And yeah, in the same breath as any plan sponsor is gonna say, high-cost claimant, they are also likely gonna say, stop-loss coverage. So you can see how this kind of fits into this trifecta here. 

So, right, this show is about stop-loss coverage, and as such, maybe you're thinking this topic sounds a little desperately boring. Like after 470 some shows, I'm scraping the bottom of the barrel. I mean, don't get me wrong, lasers or laser claims has a cool ring to it and all, but stop-loss coverage, well, it kind of needs a rebranding. 

Importance of Stop-Loss Decisions

[00:01:52] Stacey Richter: Stop-loss comes off as, I don't know, not a ringer as far as compelling podcast titles go, but do not be fooled by, its nothing to see here name. Stop-Loss is, and I'm quoting Andreas Mang, one of my guests today who would know, Andreas says that for any given self-insured plan sponsor, stop-loss is one of the most important buying decisions. I take that to mean plan success or failure might hinge on how well the stop-loss decision gets made.

But danger Will Robinson, because as Andreas says, a lot of times stop-loss decisions are one of the final calls that winds up getting made in any given plan year. So it's so easy to face these really, actually very big decisions. While completely exhausted and inadvertently kind of phone it in. But yeah, don't do that. Big mistake. 

So I gotta tell you, this episode on this topic was really a long time coming. I wanted to talk with someone who kind of didn't have a horse in the race of selling stop-loss and also knows the stop-loss, what the, what's inside and out. This was no easy task. It was almost as hard finding someone for the show as it was to find someone to talk about 340B before I managed to find in shanghai, Shawn Gremminger. But I digress. 

Guest Introductions

[00:03:16] Stacey Richter: I'm so pleased to be speaking today to Andreas Mang, who is senior managing director at Blackstone and CEO Equity Healthcare. I am also speaking today with Jon Camire, who is also over at Blackstone. Jon is managing director and CFO Equity Healthcare. Jon is an actuary and he runs their stop loss program. So yeah, you can see I'm bringing the big guns here. 

All right, logistics. This conversation about stop-loss is gonna be two shows. This show that you'll hear today will lock down the basic concepts, dispel some myths, including the nuances of laser claims, and wrap up with the hugest of huge, you better get this right or things can go horribly wrong.

Which I'm not gonna keep you in suspense over the hugest of huge is pick a really, really good consultant and know how they are paid. It is easy to say this, and you might be, yeah, yeah, yeahing me. I've heard this before so many times. But after listening to Andreas and Jon talk through some of the stuff that we talked through today, it can be a scalding, really expensive hot mess.

So, wow. Yeah, it just drives home why a really experienced unconflicted consultant matters with three underlines. 

The second show will cover major fails, mistakes that happen with stop-loss when somebody doesn't understand or do everything that we talk about. So tune back in for the next part of this convo, as I said, in two weeks.

I will also mention the earlier show that I did with Andreas, it was about a year ago, comes up a bunch of times in the show today. We reference it because as I said, we talk a lot about the role of the broker in stop-loss and purchasing stop-loss, and we also talk at great length about brokers in that earlier episode. Link in the show notes as usual for your convenience. 

Normally right now I say my name is Stacey Richter, and then I say, this show is sponsored by Aventria Health Group. What I'm going to say instead today is that the show is also sponsored by Havarti Risk, which I am very thankful for. The show actually does cost an unexpectedly large sum of money to create and produce, so I always appreciate when somebody offers to sponsor a show or help sponsor a show.

Havarti Risk empowers healthcare leaders like you to make smarter decisions that increase quality and lower the cost of care. Havarti's cutting edge approach combines deep industry knowledge and also actuarial expertise with advanced technology to transform how you manage risk and optimize performance.

Imagine having the power to, number one, predict financial outcomes, both claim and admin with confidence. Number two, measure performance across value-based care contracts in real time. Number three, validate ROI on health innovations, ensuring better care delivery at greater efficiency, like for example, build a tracking mechanism to measure and validate ROI's, return on investments.

And then number four, develop novel capital risk structures tailored to your organization's unique needs. So do please support Havarti Risk. You can visit them at their website, which we will link to in the show notes to take the first step toward greater visibility and control of risk outcomes in your business.

And once again, thank you so much to Havarti Risk for their financial support of this show. 

And with that, here's the first part of my conversation with Andreas Mang and Jon Camire about stop-loss. 

Andreas Mang, welcome to Relentless Health Value. 

[00:06:56] Andreas Mang: Hey, Stacey, thanks for having me back. Happy to chat about stop-loss with you today.

[00:07:01] Stacey Richter: It is a pleasure to have you back. Jon Camire, thank you so much for being here today. 

[00:07:05] Jon Camire: Thank you, Stacey. It's a real pleasure. 

Defining Stop-Loss

[00:07:07] Stacey Richter: Why don't we start from the very beginning. Let's define terms here. What is stop-loss? 

[00:07:12] Andreas Mang: For most people, they probably hear this and they are already asleep. Hopefully not. 

[00:07:16] Stacey Richter: They're running for the hills.

[00:07:18] Andreas Mang: Yeah, they're running for the hills. I'm gonna encourage everyone to keep the play button hit and to listen to this because in as much as it may sound sort of mundane, or not exciting. It's probably one of the most important topics for a self-insured company because what it is, is stop-loss, really, it's a form of reinsurance, and it is the insurance that is purchased by an insured entity, and we'll talk about what that is, to protect against catastrophic loss. 

Okay, so it's the protective layer that essentially removes a tranche of risk for an insurer, and that insurer can be an insurance company, like a property and casualty insurer. I can assure you that those that insured the homes that were devastated by the fires out in California are probably covered by reinsurance. I'm sure they are. 

It could also be a self-insured entity, right. And the stop-loss, which is the reinsurance that a self-insured entity purchases, the amount that they purchase is relative to the size of the risk pool. 

[00:08:22] Stacey Richter: So you're saying that if I say reinsurance or I say stop-loss, those are synonyms.

[00:08:27] Andreas Mang: I'd say stop-loss is a subset of an overall umbrella known as reinsurance. So reinsurance broadly is what we discussed. It's the insurance purchase to protect against catastrophic coverage. Underneath that umbrella of reinsurance, we have stop-loss and other forms of insurance that people can buy to protect against risk.

There's insurance products for gene therapy if you want, but in general, stop-loss is a form of reinsurance that is a comprehensive form of insurance that should cover all expenses above a certain threshold. 

[00:09:08] Stacey Richter: And we're basically saying that you are a self-insured employer or whoever's listening. If we're a plan sponsor here, we may be confident and capable of managing day-to-day kinds of risk, normal kinds of risk, but if something absolutely nuts happens, we can't bankrupt our whole company, so therefore we need a stop loss. We need some kind of coverage so that we protect in the chance that something really bad happens. That's the very simplistic explanation here. 

[00:09:41] Andreas Mang: That's right. It's actually funny in healthcare coverage, what people are getting today from employers or from an insurance company, it really isn't insurance anymore, right? Insurance, by definition, should be low probability, high cost events, that's what insurance covers. 

[00:09:57] Stacey Richter: Listen to the show with Ge Bai where we dig in on that exact concept. 

[00:10:01] Andreas Mang: And I'd say stop-loss coverage is still one of the few pieces of this overall puzzle that still meets that criteria. low probability, high-cost events

Stop loss should be for those low probability, high-cost events that a self-insured employer wants to protect themselves from. And quite frankly, it has been, historically, it's been one of the barriers to smaller companies going self-insured because this protection can be fairly expensive.

Because why? Because I said before that the amount of protection that you buy is relative to the size of the risk pool that you are insuring. So if you are small, if you're a very small company, let's say you're 400 employees and you're self-insured, your appetite for risk is gonna be less than that. Of, say, a company with 5,000 employees and what is essentially your coverage, your deductible is going to be much lower than that of a company with 5,000 employees.

So if you're 400 employees and you're buying stop-loss, you're gonna buy coverage that has a deductible that's quite low, probably in the, could be 75, could be a hundred or $125,000 deductible, meaning that you're on the hook for the first, let's say the deductible is a hundred thousand dollars. They call it an attachment point, and this is for a form of stop-loss that we call individual stop-loss. There's actually two forms, I should have said that before. 

Individual vs Aggregate Stop-Loss

[00:11:19] Andreas Mang: There's two forms of stop-loss for a self-insured entity. There's individual and there's aggregate. Individual says for an individual situation, an individual case, you the employer, are on the hook up to a certain threshold.

Whatever that deductible is that we set, let's say in this case it's a hundred thousand dollars. If someone has something bad happen, they're going through cancer, for instance, you, the employer, will be on the hook for the first a hundred thousand. After that, you are free and clear. The stop-loss carrier is gonna pick up the rest.

Now, if you're 5,000 employees. That deductible may be $750,000. It could be up to a million dollars because you're much bigger. You're more able to absorb those higher cost expenses within the overall budget of your plan. 

[00:12:02] Stacey Richter: What I'm understanding you say is that stop loss obviously is it's protecting a self-insured entity, employer plan, sponsor of some kind against some kind of catastrophic situation or maybe situations that happen in any given plan year such that that plan winds up with way more expense for healthcare than they had budgeted. 

And it's interesting that you put a small employer at 400, which I know from the last episode you said was you're pretty much bottom for what you would consider someone should be self-insured. Is about 400 employees. So we've got a small 400 person employer here or a plan. And you said there's individual stop-loss and then there's aggregate. 

And if we're thinking about the individual, then if any claim exceeds for the smaller employer, maybe they're, you call it a deductible, which is kind of interesting because normally we think about deductibles as as patients, but if we're thinking about it at the plan level, this is the plan's deductible. At about a hundred K for that given individual. So you have one individual who has some kind of very high-cost claimant. The stop loss carrier's gonna pick up anything that's above the a hundred K or whatever the floor is on that.

And if it's a larger plan, then obviously they've got more money they can absorb a higher high-cost claimant. So maybe it's 175 if it's a larger plan. Did I get that right? 

[00:13:24] Andreas Mang: You got it right. And I'd add that if you're large enough, some companies go without it. So companies that are around, call it, eh, it's around 10,000 or so employees on their plan, they actually can start thinking about completely eliminating this.

[00:13:39] Stacey Richter: The individual, you mean? 

[00:13:40] Andreas Mang: The individual. So think of it as a, you know, Jon will probably talk about this, think of it as a risk management tool that we oftentimes will say, look, this decision needs to be, and I talk about this a lot, joint with finance and HR. I think everything with self-insurance should be a joint decision between finance and HR.

But this really is a CFO decision because it is a risk management tool. It is a risk management decision. How much risk are we willing to take on the balance sheet of our company. 

[00:14:10] Stacey Richter: Before we get to the next question where we talk about aggregate. Jon, do you have anything that you wanna fold in here to this conversation?

[00:14:18] Jon Camire: I would just say that, you know, to put some numbers around what Andreas was just saying, when you have a company that has 10,000 employees, they could have a plan that's running $10 million a month in claims, and so you know, a claim that's 250,000 or 500,000, really isn't something that becomes catastrophic for their cash flow in a way that it does for a smaller plan that might be running 200,000 a month. They have a claim for $500,000, that's really a major hit on cash flow. 

And when you think about stop-loss insurance, and really what you're trying to do is understand the risk tolerance of your specific company, your cashflow needs, your cashflow limits, and put some insurance around it so that you do not result in a bad situation.

[00:15:03] Stacey Richter: And I think what you just did there is put an underline under what Andreas was just talking about, about how stop-loss is a risk management tool. This is all about understanding risk tolerance, and then finding a level of stop-loss coverage that seems suitable for that risk. And that sounds like something the finance department should be all over.

So as you say that this definitely should be a joint decision with finance, I am cottoning onto that. That sounds like it is. Correct. 

[00:15:37] Andreas Mang: Exactly. 

[00:15:38] Stacey Richter: So we just talked about individual stop-loss coverage or stop loss coverage and how that impacts maybe an individual high-cost claimant. You had also mentioned there's two kinds and the second kind is aggregate. So what's that all about? 

[00:15:51] Andreas Mang: Sure. So aggregate is the second form of stop-loss. 

[00:15:56] Stacey Richter: But this is all within one policy, right? So you have stop-loss and then you've got the individual component and the aggregate component, or is this a whole separate policy? 

[00:16:03] Andreas Mang: It's really separate. It's a separate decision.

So what aggregate insurance is going to do is it's gonna cap your overall risk. So it's gonna end generally with that's where that's set. It's generally set at about 125% of your expected cost, so it sort of sets a maximum or a ceiling that you as a company will pay in a given year and in general, aggregate reinsurance, aggregate stop-loss is purchased by smaller companies.

When you get to be about a thousand employees or so. You generally see companies eliminating the aggregate policy and it's cheap. This is the piece that doesn't cost a ton, but it's also hard to engage it. So I asked our stop-loss sort of administrator once, what's sort of the average? How many times do you see a company hit the aggregate stop-loss?

If you think about, again, it's at 125% of your expected, your forecasted amount. That's a pretty big miss. If you're hitting that, they said one out of a hundred years you're gonna hit it as a company. So it's nice to have it. It gives people peace of mind. It doesn't cost much, but in general, you're not gonna hit it. 

Think about what you would need for that to happen. You have an individual policy in place. Let's say it's a hundred thousand dollars individual policy. To hit aggregate, you'd have to have something really strange happen where you have a whole bunch of cases that are just coming in right below that where individual may not be kicking in and a whole bunch of somethings happened that sort of ended up where you were way beyond your budget or, or you did a poor job before forecasting your expenses, which could also be the case.

But again, in general, aggregate is something that goes away once you're large enough because why, you know, basic principle of insurance, the larger the risk pool, the easier it is to kind of forecast and understand where things are gonna go. 

[00:17:52] Stacey Richter: Yeah. This sounds like a lot of really heavy duty looking at past trends, trying to figure out exactly like you just said, what is the risk here?

So I'm glad we have an actuary in this conversation. 

[00:18:05] Andreas Mang: Well, so am I, you know. This brings legitimacy to this whole thing. But look, you know, we've talked, we talked about this last time, you had me on the importance of having a good broker, a good partner, because the, we always say the math gets so much more complicated when you're self-insured.

And for those who maybe didn't hear the first time I was with you, Stacey, you know I talked about self-insurance. As companies are running their own health insurance company, when you are self-insured, you're running your own health insurance company. You need to be able to forecast risk appropriately.

You need to be able to forecast where are the potential areas where you could get hurt sort of financially. What are these protective layers of insurance that you need to make sure that your plan is run in an efficient way, in a smart way, in a way that protects you as the self-insured entity? It gets complicated, right?

And this one right here is square in the bullseye of where problems can occur. And Jon will talk about this in a bit, but we have seen some really interesting things in our time here over the years where companies are not structured properly with this insurance and they face some real, you know, unforeseen expenses.

So it's important to get this one right. It is complicated. And this one really highlights this sort of notion that when you're self-insured, you're really running your own insurance company. And stop-loss is one of these key provisions that all insurers have. Right? So if the insurers are doing it, you better be doing it as well in the situations where it makes sense.

[00:19:29] Stacey Richter: Yeah, because you buy too much, you wind up spending a lot of unnecessary dollars and kind of mitigate the whole point of, not the whole but a point of being self insured to begin with. But you don't spend enough, you can get in a lot of trouble if the worst winds up happening in any given plan year. 

[00:19:48] Andreas Mang: It's such a great point.

Stacey, I just wanna highlight what you just said. We've seen so many companies who in their first year of going self-insured, they're nervous, right? They're a little apprehensive about taking on this risk. And oftentimes we see companies who initially have the knee jerk reaction to over insure, and this coverage is expensive, you know, make no mistake there.

And so, choosing the right levels and having a partner who can help you with that math and project your risk and do it in a way that is best for you and your situation is really important because it can completely turn the economics upside down of going self-insured. 

[00:20:24] Jon Camire: Just to add new company going self-insured. Everything about stop-loss is gonna be unfamiliar. All the terms, all the decision points are gonna be unfamiliar for a company that has just been making decisions in a fully insured world. And so, you know, you may not really understand where the blind spots are, and that's where that consultant comes in. So important. 

[00:20:47] Stacey Richter: And I also could see, again, just kind of going back to the whole, who within any given plan, sponsor owns this whole thing. I mean, finance is actually making a lot of these types of decisions for all the other insurance they're buying, which probably is coming out of the finance department, right?

Like for their property, for workers' comp, like for all those other things. So like as we talk about these unfamiliar words, they could be very unfamiliar for someone in HR who likely did not go to get a human resources education to, as you say, run a small insurance company off the side of their desk. Right. But at the same time, like this is sort of very financey, even just in terms of language. 

Understanding Laser Claims

[00:21:29] Stacey Richter: Alright. What's a laser claim? 

[00:21:31] Andreas Mang: What an awful title. What an awful name for a piece of this overall game. So what a laser claim is this, if you think about, if you put yourself in the shoes of the reinsurer, the stop-loss carrier, they like, you are also projecting risk, right?

So they're looking at your claims data. They're trying to understand what's their exposure, and in turn, they then wanna price your policy appropriately. What a laser is, is when there is a known risk. So let's say someone is going through some kind of a prolonged treatment. Again, let's use the example, I hate to use it, but you know, it's appropriate for the, for the discussion.

Someone is going through cancer. And let's say they started treatments in November and they're gonna be flowing into the next year, and your plan year follows the calendar year. So you're facing a renewal and you go to the market and you're looking for a new policy or you're looking for a renewal rate.

That reinsurer, the stop-loss carrier is going to see that risk in your population because they have your claims data. And that's the equivalent of knowing if you're a property and casualty insurer, that's the equivalent of knowing an earthquake is coming, right? So you see that risk, you see that that cost is in there, and what a laser does is it pulls out that individual person from the risk pool.

And in general, what they usually do is they set a different deductible for that individual. So your individual stop-loss policy may be set at, let's say, you know, $350,000 deductible, but for that person, that individual, they laser them out, and that person may have a $500,000 deductible. So you are on the hook for a greater piece of the overall cost.

That's what a laser is. It's pulling out known risks, and it's assigning a different financial threshold to that known risk. 

[00:23:17] Stacey Richter: So basically if there is an individual or individuals who, they're crossing the plan period, as you said, right? Like they start a treatment or have some kind of chronic something or other where they begin in one plan year, but then it crosses the renewal period of the stop loss.

Exactly like you just said, the stop-loss carrier's, like, I'm onto you. I see that is gonna happen. So at this juncture, you don't need insurance. You need someone to pay your bill. If I'm just thinking about it from a, you know, from the perspective of this other entity that is on the sales side of the equation and on the, on the hook side of the equation.

So a laser claim is them basically saying, you're gonna have this expense and you need to figure out what to do with it. Like at this juncture, it's not insurance, it's a known entity. 

[00:24:06] Andreas Mang: As you said perfectly, it's no longer insurance. It's a known thing. Now, you know, obviously something that's episodic and that you expect to resolve hopefully in a positive way.

On the employer's side, they're trying hard to say, Hey, this, this is either the individuals at the end of their treatment or they've gotten better, or the claims you're seeing are no longer gonna be carrying forward. The employee may no longer be with the company. There's a number of discussions that happen to understand where that person is versus, and you just said this as well, someone who's chronic, right?

A hemophiliac who's gonna be on the plan is, we know is going to generate quite a bit of, expense going forward that's gonna carry on for the foreseeable future. That is gonna be treated slightly differently as well. But, but in a, you know, in a nutshell, you, you nailed it. That's what a laser is. I wish it had a different name.

[00:24:55] Stacey Richter: It sounds a little too exciting maybe for what it actually is, which is not good, generally speaking for both the company as well as the individual that is involved. 

So Jon, before we move into the next question I have for you, which I'm very excited to get to, is there anything that you wanna kind of add in summary for what we just talked about there?

[00:25:17] Jon Camire: Yeah, look, I would say that a laser, it sounds like it's bad, but actually there are situations where companies should be pleased that a laser is being offered. So basically what that means is the insurance company underwriters for that company have evaluated that risk and they feel like there's a greater risk there than they wanna accept.

So they're gonna ask for a high deductible for that individual. But what that means is they're not gonna build that into the premium. So the alternative is they don't laser that claimant and then they just throw a couple hundred thousand extra onto the premium and you don't really know the difference.

So, you know, one of the things I think is an important principle with stop-loss is to, you know, market and get different perspectives from different carriers. But we've certainly seen situations where accepting the laser on one policy is a 100% financial winner relative to another policy that's being offered that doesn't have a laser, but just has a much higher premium.

So, these situations are all unique. They're all individualistic. You have a variety of different clinical factors, financial factors, all kinds of things, but each one is individual. You have to evaluate them each year, each policy, and then make a good decision. 

[00:26:34] Stacey Richter: Yeah, so that's really interesting that if you get a stop-loss carrier, like I'm, here's a totally exaggerated reenactment, but the employer might be like, oh no, don't laser my claim thinking that that's a good thing.

And the carrier's like, sure. And then they just added into the premium what the employer would've paid for anyway, probably with some additional dollars there. I mean, basically what the employer may have just purchased is a very expensive payment plan. 

[00:27:00] Jon Camire: Absolutely. That's exactly what happens. The margin on these products is high.

So if it's as an Andreas example, 350 versus 500,000, they're not just gonna add 150,000 to the premium. They're gonna add, you know, 250,000 to the premium and that's what you're gonna eat. And we've certainly encountered companies that are like, we hate lasers. We don't like lasers. And you know, obviously in isolation, sure. But each situation needs to be evaluated individually. 

Key Takeaways and Consultant Importance

[00:27:27] Stacey Richter: So my next question for you, Jon, is what's most important here to know? Like if you were going to select a tip-top rate critical, what would it be? We just talked about how it'd be important to know stuff like, “Hey, not all lasers are a bad thing.” And I am inferring from what Andreas mentioned, that a good broker or consultant would know about stuff like this. But what's most important here? 

[00:27:55] Jon Camire: Well, there's definitely a few things. I think actually right in your question, maybe the top thing, it's time. You know, when you're stepping up to evaluate self insurance or even considering evaluating self insurance, it's really time to take a hard look at who your consultant is and maybe at that point you're calling a broker.

I really feel like once you get into self insurance, the consulting piece becomes more critical, right? The math gets a little harder. The work gets a little more complicated. You have more flexibility and stop-loss is only one of those areas. 

But one of the things I like to say to companies that are in this space where they're considering self-insurance is, when you're fully insured, it's a lot like ordering a meal at a restaurant. You're looking at the menu, you see the prices, and you're making a decision. 

With self-insurance, it's a lot like going to the grocery store, picking out groceries, cooking the meal. It's more complicated. It's likely to cost you less at the end of the day than going out to the restaurant, but the person or the consultant that can help you do that, I like to say it's not the same person that can order a good steak, that can cook a good steak. And so that's really where comes in. That consultant is gonna be critical. 

[00:29:04] Stacey Richter: All right, so we have gone through today, we have talked about what stop-loss is. We have talked about these terms that wind up getting bandied about relative to stop-loss. We have talked about making sure that the consultant knows what they're doing because this sounds very much like something that one would need an experienced guiding hand to accomplish.

Is there anything that we neglected to talk about that we wanna bring up today? 

[00:29:28] Jon Camire: The one thing I wanted to add is make sure you know what your consultant is getting paid, and if you're using some type of collective or captive or whatever, make sure you know what they're getting paid. Over the years, we've seen some questionable behavior when it comes to commissions on stop-loss because it's not an employee benefit.

It's not reported on 5500s. If you have that reputable broker. You're doing disclosures and things like that, you're probably okay. Same thing with a strong collective. Definitely know what these people are being paid on this coverage. 

[00:30:02] Stacey Richter: Yeah, I think that's really good points. Andreas, anything that you wanna add as a wrap up here?

[00:30:07] Andreas Mang: This stuff is complicated. I hope it doesn't scare anyone away. I hope this helps clarify some of the important points that you need to look at. And it's just, it's a really integral, important part of the overall self-insurance equation that is too easy to sort of view as that last buying decision that we talked about and sort of you wanna sweep it under the rug.

It's probably one of the most important buying decisions. Unfortunately, it happens at the way end of the process when everybody's really tired and beat up and you know, you gotta hang in there and get through this one and put as much into it as every other part of what you've done to sort of structure your plan for your employees.

Conclusion and Next Episode Teaser

[00:30:42] Stacey Richter: Okay, you listening right now, consider yourself informed about the basics now. So let me tell you what you gotta do in two weeks. Tune in and listen to part two of this discussion where, yeah, we talk about the biggest mistakes plan sponsors make when it comes to stop-loss and a bunch of other, I don't know, pretty, for me, at least, unintuitive and also rarely discussed aspects of this whole conundrum. Just as unintuitive as, Hey, sometimes a laser isn't a terrible thing if you think it the whole way through.  So see you on the other side. 

Andreas Mang and Jon Camire, thank you so much for being on Relentless Health Value today. 

[00:31:21] Andreas Mang: Happy to be here. Thanks so much for having us.

[00:31:23] Jon Camire: Thank you, Stacey. 

[00:31:24] Keith Passwater: Hi, I’m Keith Passwater, an actuary Havarti Risk. Listening to Relentless Health Value has consistently challenged the way I think about healthcare, and it’s given me answers to the question, how can we actually make healthcare work for the patients, the doctors and nurses, and all those paying the bill? The conversations unlock clever ideas that are smart, relevant, and grounded in the realities we face every day.

If you’re as passionate about driving meaningful change in healthcare as I am, I really encourage you to subscribe to the newsletter. It’s a great way to stay in the loop and be notified about new episodes. Thanks for listening.