Description: The US healthcare system is among the world's most advanced, but is the highest-cost by far. At Swiss Re we studied the highest-cost US Medicare beneficiaries during 2016. The Medicare government program primarily covers seniors and individuals with disabilities. Total Medicare spending during 2016 was nearly USD 700,000,000,000. In our study, the 1% of beneficiaries with costs of USD 125,000 or higher generated 15% of total claim costs. Better understanding of these beneficiaries and their treatment could lead to improved quality and efficiency of care. Analysis of their claims can aid projections of the expected level and variance of costs. We calculated claim costs and rates, and identified higher-cost segments (including inpatient claims, individuals with disabilities or end-stage renal disease, Pacific states including California, and men). We look forward to expanding the analysis in future updates.

Description: Meditation on life, choices and events during the COVID-19 pandemic

Description: This article discusses a multiyear design for stop-loss reinsurance used by employers offering self-funded medical benefit programs.

Description: Feature article with helpful hints on video conferencing and more!

Description: This article overviews the results of the 2008 survey of Third Party Administrators of Employer Stop Loss business.

Description: In the last 10 to 15 years, new health insurance programs have proliferated in the Latin American and Caribbean regions. The reason for this boom has been, basically, the need for insurance companies to identify and implement new or additional lines of insurance business in order to match or exceed the increased numbers of competitors now working in these markets. This is combined with the stronger reinsurance capacity that these insurance companies had access to, which can be attributed to the need for increased reinsurance protection that arose a number of years ago, when many insurance and reinsurance companies were seeking larger volumes of businesses based on the expected growth potential of the region.

Description: The recent outbreak of the Zika virus (ZIKV) in Brazil and in at least 29 other countries and territories is a stark reminder of the risks associated with new, emerging and reemerging infectious diseases. This article is intended to provide essential background information on the Zika virus in order to assist insurers’ understanding and risk assessment of the situation. Insurers must continually stay abreast of these risks and rapidly assess the potential impact on morbidity and mortality – often with only preliminary scientific or actuarial data

Description: First dollar carriers, stop loss carriers, and reinsurers play a different role in reimbursing healthcare claims. This article explores the reinsurer's role in reimbursing COVID-19 related claims.

Description: Summary of current state of A&H reinsurance business.