Facing Risk and Doing the Right Thing

At HM Insurance Group, we know first-hand that life is not without risk. Each year, we see thousands of claims tied to unexpected medical events that individuals experience and how those situations impact the employers providing their medical coverage. Bad things happen out of the blue – and Stop Loss helps mitigate the financial risk to self-funded employers. 

A difficult part of this job is seeing the largest claims come from the sickest people, knowing that these situations rarely have happy endings. No one plans on getting sick or injured, but the advances in medical technology have been amazing over the last 30 years. These advances, however, come at a price. Since limits were lifted off health insurance policies in 2010, the costs tied to the most complex claims have risen to levels most of us could not have imagined. But when it’s for ourselves or a loved one or an employee, we all want access to the best our health care system has to offer.

For employers that buy Stop Loss, we step in and assume the risk above their deductible. An HM Insurance Group Stop Loss policy gives employers financial security, limiting their downside risk to high-dollar claims. This makes their benefit plan more affordable and allows these employers to focus on what they do best – running their businesses.

There’s a lot of discussion in the media on the rising cost of health care, and Stop Loss is the most volatile portion of the overall system. Our premiums are leveraged by the deductibles (on typical Stop Loss deductibles, our premiums are about 5% to 15% of an employer’s total health care spend), and the incidence and severity of the largest claims are highly variable. 

I did not have receiving and paying a $20,000,000 claim on my HM Insurance Group bingo card for 2024. That said, we did receive one – and we paid it – in a timely manner. We upheld our end of the bargain. When situations like this – which are unfortunate on every level imaginable – come up, we step up and do the right thing for our clients.

There are very few employers in the US who can cut a check for $20,000,000 to pay the hospital bills for one of their employees. Helping employers pay their high-dollar claims is a very important part of financing the US health care system. In some ways, it might be ideal if our product wasn’t needed, but in our current environment, the need for Stop Loss insurance has never been greater. 

I’m very proud of the role HM Insurance Group plays in the health care system, and I’m proud of our employees who work hard every day to do the right thing for our employer group clients. Life is not without risk, but there is less risk for self-funded employers with an HM Insurance Group Stop Loss policy.