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Insights

State of the Stop-Loss Market

7/2/2026

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The medical stop loss market remains under pressure from worsening loss ratios, higher-cost claims, and elevated utilization.  Stop loss carriers are anticipating persistent pressure through 2027  and are targeting 27%-30% rate increases.
 
Lockton suggests employers should move beyond treating stop-loss as an annual insurance purchase and instead adopt a more strategic approach that includes earlier planning, stronger data management, optimized risk retention, evaluation of alternative funding vehicles, and proactive management of high-cost medical and pharmacy claims.
 
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Based on Lockton People Solutions' June 2026 stop-loss market update and our Alternative Risk Playbook, employers should consider the following actions:
  1. Start the Stop-Loss Renewal Process Earlier
    • Carriers are requesting more detailed and current claims data, and underwriting decisions are being made later in the renewal cycle. Employers should begin budgeting, risk-transfer discussions, and renewal strategy meetings earlier to avoid last-minute decisions and maintain negotiating leverage.
  2. Reevaluate Specific Deductible Levels and Risk Structure
    • Given the significant increase in claim severity driven by specialty pharmacy, oncology, and gene therapies, employers should evaluate whether higher specific deductibles, aggregating specific deductibles, or strategic use of lasers can improve the balance between premium costs and retained risk. 
  3. Improve Claims Data Quality and Reporting Readiness
    • Successful stop-loss underwriting increasingly depends on clean, timely, and complete medical and pharmacy claims data. Employers should strengthen internal reporting processes and work closely with TPAs, PBMs, and consultants to ensure data can be produced quickly for underwriting review.
  4. Explore Alternative Risk Financing Solutions
    • Captives, consortiums, purchasing groups, and hybrid risk-sharing arrangements are gaining traction as employers seek greater stability and transparency amid volatile stop-loss renewals. These alternative funding approaches can help smooth year-to-year fluctuations while providing more control over long-term healthcare risk financing.
  5. Address High-Cost Claim Drivers Proactively
    • Employers should focus on managing catastrophic claim risks, particularly specialty pharmacy, cell and gene therapies, and oncology treatments. Effective pharmacy management, clinical oversight, and large-claimant monitoring can help reduce stop-loss volatility and improve renewal outcomes.

Reach out to [email protected] for more information about evaluating alternative risk solutions for your business
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Lockton's 2026 Benefits Survey: Everyone Is Feeling the Pressure - Few Are Making Big Moves…Yet

5/7/2026

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​Rising healthcare cost has officially taken over the conversation according to Lockton's 2026 US Benefits Survey

Cost pressure isn’t new. But the urgency behind finding solutions and not disrupting employees is causing some tension inside US companies.

This tension is stemming from groups that generally focus on different outcomes.
  • HR is optimizing for: 
    • Talent attraction/retention 
    • Employee experience 
    • Compliance
  • Finance is optimizing for: 
    • Cost predictability 
    • Margin protection 
    • Capital allocation discipline 
It’s important to remember that both are right. We’re just solving for different outcomes with the same dollars.

Managing rising costs is the primary decision-making driver 
Employers have always cared about cost. But 2026 marks a clear shift in how much.
  • 54% of employers now say reducing cost is the top factor in benefits decision-making - up sharply from 38% just one year ago
  • Meanwhile, talent attraction and retention has dropped to 19% as the top priority in decision making - down from 30% in last year's survey.
The trend that started last year is now a reordering of priorities.
And here’s where it gets more interesting:
  • 81% of employers still say employee impact is a primary consideration
And so we end up with a balancing act - cut costs and  don’t upset employees.
That’s a constraint to strategy and implementation. As such, employers are increasingly asking for more help from their brokers and consultants.
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Everyone’s Looking for Answers
You might expect that kind of pressure to drive bold action.
It hasn’t…yet.
Instead, the survey shows a market that’s experimenting:
  • Employers are testing different cost-saving strategies, leaving no stone unturned
  • Progressive approaches to specialty drug and chronic condition management as well as captive stop-loss arrangements are under serious consideration.
  • No single approach has emerged as the clear path forward 
  • Companies are taking the time to learn more about disruptive strategies such as ICHRAs, RBP and spousal exclusions.
In other words, organizations know they need to do something—but they’re still trying to figure out what works without creating too much disruption.
Another example shows up in network strategy:
  • 94% of employers still offer broad national networks
  • When narrow/high-performing networks are used, they’re often offered as an option
Bottom Line: Employers want savings and are not yet ready to force change.
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Incrementalism Prevails
When zooming out, a consistent theme emerges - most employers are choosing incremental and progressive changes over structural, disruptive ones. For example,
Eligibility & Plan Design
  • 23% apply spousal surcharges (up from 20% in 2025)
  • 13% exclude spouses with access to other coverage (up from 9% in 2025)
  • Almost 3% exclude spouses entirely (up 300% from 2025)
Pharmacy Strategy
  • 67% still bundle pharmacy with medical plans
  • 26% carve out specialty drugs from PBM
  • 3% are requiring specialty onsite cost of care management
Affordability Efforts
  • 59% offer lower-cost plan option
  • Only 10% use income-based contributions 
These are real actions. They’re measured, limit disruption, avoid big tradeoffs and they tend to produce measured, incremental results.
Targeted Investments Continue
Despite rising cost pressure, employers are still investing in their people. While reducing costs is the top priority for survey respondents, it is not the only consideration. Notably, 17% of plan sponsors rank improving quality of care as their top priority.
Selectively, where the data, utilization and benchmarking justify investment, it’s happening.
  • 73% say employee wellbeing programs remain a priority
  • 63% offer enhanced EAPs for behavioral health support
  • 24% of employers covered GLP-1s for weight-loss and another 24% are actively considering it if eligibility is coupled with a lifestyle management program.
  • Advocacy and navigation services continue to grow year over year 
This is a shift toward targeted investment—focusing on areas tied to high-cost claims or meaningful uplift to employee experience.
What This Really Means for Employers
The headline isn’t just that costs are rising. It’s that the current pace of change doesn’t match the current level of pressure. That combination naturally leads to slower, more cautious decisions. And the risk is incremental action in a non-incremental environment.
The 2026 Lockton Survey makes clear that maintaining the status quo is no longer sustainable and the questions heading into 2027 become:
  • Which plans and strategies have strong utilization and are showing value?
  • Where are you willing to accept disruption?
  • Which tradeoffs are worth it? For instance, would you accept an incremental 3% cost increase for a 1% reduction in turnover?
  • How long can incremental change keep up with accelerating costs?
These are not easy conversations but they’re the ones this data is pointing toward.
Final Thoughts
While the 2026 survey doesn’t point to a single winning strategy, it does show that the US benefits market is in transition caught between:
  • Financial reality
  • Employee expectations
  • And organizational hesitation
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Lockton's Complex Claims Management & Medical Consulting

11/25/2025

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Since 2019, our integrated approach to Complex Claim Management, Medical Consulting & Stop-Loss Brokerage has resulted in
  • $456M of verified claims expense reductions
  • $186,000 average claim reduction per case 
and in 2024, 
  • $80.4M of verified claims expense reductions
  • 17,630 member cases reviewed
and more than $100M in 2025 so far...

CLICK BELOW to learn more about how our Complex Claim Management practice improves care and saves money  


LEARN MORE HERE
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Stop Loss Renewal Season 2026:  Challenged & Confused

11/12/2025

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Employers are navigating the most challenging stop loss renewal season in decades. We’re sharing what we’re seeing in the market, why it’s happening and what we recommend you could do to address it.

This isn’t just a tough year. It’s a convergence of market disruptions and a shifting carrier landscape. The result? A storm of complexity and confusion that will continue.

Is The Market Hardening or Confused? Maybe you’re hearing the term “hardening market” tossed around and depending on your circumstances, that may or may not be what’s happening. After spending time with the largest carrier CEOs over the past few weeks, the consensus is clear: the market is confused.

​Here’s why:
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  • Loss Ratios Are Surging
Industry-wide stop loss premium now exceeds $40B, and loss ratios are up to 85%—well above the historical target of 75%, which itself is 10–15% higher than a decade ago. Carrier leaders are calling this “unsustainable,” and many expect a 3–5 year correction cycle. Carriers are reinsuring themselves at a higher rate than prior years signaling their concerns with risk, volatility and rising cost.

  •  Capacity Is Up, But So Is Pressure
More capacity is creating a bookend effect. Employers with favorable experience are still seeing rate passes or decreases. On the flip side, employers with poorly performing experience are getting hit hard—resulting in as much as 300% year-over-year increase and initial renewals hitting rate caps.

  • It May Not Be Textbook, But It Feels Hard
The textbook definition of a hard market are premium increases coupled with decreases in capacity and available terms. While it’s encouraging that capacity is growing, if you’re getting a steep rate increase or losing favorable terms, it feels hard…very hard.

What Does This Mean for Employers?
  • Average Rate Increases Are Rising
    Carriers are targeting 22–29% increases across their blocks for 2026, up from 17–22% last year. For comparison, Lockton clients purchased at an average 12% across our $2B+ block last year. As a result, clients who hadn’t felt the pressure to take on more risk, so deductibles remained lower than market norms. To offset proposed increases, clients are reviewing deductibles using tools such as Monte Carlo to determine acceptable risk / cost levels.
  • Renewal Timelines Are Compressed
    Carriers waited for September data to make underwriting decisions, which pushed the renewal timeline back by a full month over prior years’ experience. That’s putting pressure on our clients and consulting teams. Nine months of data (through September for January renewals) is now the norm, with very few exceptions. Early lock offers (before the 90-day mark) are now seeing premium loads of 7–12% because claims haven’t fully materialized. The delay in renewal and alternative proposals is a clear reflection of broader market uncertainty.

Other Trends We’re Tracking
  • Fewer Rate Cap / No New Laser contracts are being made available.
  • Claim denials are increasing, likely driving up E&O exposure.
  • Carrier performance metrics are tightening underwriting behavior.
  • Providers are using AI in managing complex cases and driving claims costs.
  • Reimbursements are taking considerably longer creating cash flow burdens for plan sponsors​.

How Can Employers Navigate This Market?
We recommend several strategic solutions to help employers navigate the increasingly complex and costly stop loss renewal environment for 2026 and on a go forward basis.

Start the process earlier in 2026 We have seen a delay in renewals and proposals as carriers waited for September claims to firm up / finalize their proposals. Leverage reporting from your broker, consultants and carriers to start these conversations early in 2026 and create an ongoing cadence throughout the year. While the early lock options (if available) may carry premium loads, these options should be on the table along with those listed below.


​Increase Deductibles Strategically
Using data and actuarial tools, raising deductibles to manage premium costs and absorb manageable risk is a proven approach. Monte Carlo risk analysis helps clients determine the appropriate deductible level given risk tolerance, claims utilization, predictive analytics and other factors. In fact, deductibles are being increased at nearly twice the rate this year as compared to 2024. For example, one client had maintained a $200,000 specific deductible for 7 years. By raising the deductible to $350,000, they were able to save 40% in stop-loss premium and receive better terms. This trend is expected to continue as employers seek to balance cost containment with coverage.
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Monitor and Track Claims
Using technology to track claims through not only financial benchmarks but clinical triggers that flag claims for review. Reporting and tracking on reviewed claims will reveal common issues such as
  • Site of care alternatives
  • Potential coding errors
  • Aberrant pharmacy utilization
Major issues are generally infrequent but significant dollars are involved when identified. In addition, this reporting can project future costs as well as support more accurate underwriting and strengthens the employer’s position during renewal negotiations.


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Use Predictive Modeling and Data Analytics
Leverage both internal and external resources for:
  • Predictive modeling
  • Historical large claimant analysis
  • Premium benchmarking
This allows for earlier evaluation of renewal ratings and supports more informed negotiations with carriers.

Consider Alternative Risk Strategies

To mitigate the impact of high-cost claims, we are seeing increased adoption of:
  • Captives: Risk transfer mechanisms that redirect underwriting surplus back in-house.
  • Aggregating Specific Deductibles: This strategy helps protect against unexpected costs by accumulating claims across covered individuals rather than focusing on a single high-cost claimant.

​Press for Forward-Looking Underwriting

Given the rise of emerging treatments (e.g., gene therapies, orphan drugs), we emphasize the importance of underwriting models that account for future risk, not just historical claims data. This is especially critical as many high-cost therapies enter the market before they appear in claims history.

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Use Clinical Team Support
Clinical teams (including MD and RN support) help evaluate high-cost claimant liability as well as assist with complex and unique clinical inquiries such as
  • Support when needed during an appeal or denial process
  • Consultation around the efficacy of emerging treatments
  • Advice regarding protocols for cost management programs

Click here to Success Stories from Lockton's Clinical Teams 

​Streamline Premium Billing Procedures
Proof of eligibility, especially for COBRA and LOA, is under tighter review—leading to reimbursement delays stricter claims adjudication, and increased claims denial.  Streamlining processes for billing and collecting stop loss premiums for all third-party stop loss carriers​ provides benefits such as
  • Timely premium payments to reduce claim denials or delays.
  • Lower costs by having carriers quote premiums net of commissions and service fees, which may reduce premium taxes and overhead.
  • Enhanced client experience through a payment portal offering real-time premium calculations, reminders, and secure ACH payments.

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Reduce Reimbursement Lag
Oftentimes, delayed reimbursements have a significant adverse effect on cash flow.  Innovative financial services speeds stop loss reimbursements to help cash flow, offering greater predictability and standardization​. The frequency of $1M+ claims has increased 1,250% since 2013, We’ve seen paid claims as high as $26M. Imagine the impact to cash flow with this scenario? Speeding the reimbursement process has benefits such as  
  • Employers can receive funding within 24-72 hours.
  • Unlimited advance funding without dollar limit or timing restrictions.
  • A carved-in outcome while still benefiting from 3rd party carrier experience.​

We’ll continue to share updates as the renewal season progresses including market conditions, renewal performance, and anything else that helps you stay ahead of the curve.

If you’re feeling the pressure, you’re not alone. Lockton's model brings purchasing strength combined with open market access (no panels), transparency, clinical support and administrative simplicity, and may be different from your current consulting structure,  We’re here if you’d like to discuss the 2026 market or how Lockton might be helpful navigating these changes.
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Surprisingly unsurprising news in Lockton's 2025 Benefits Survey

4/17/2025

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Increased Focus on Cost but...Slow to Action

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As employers are planning their 2026 benefits strategy, managing costs has overtaken attracting and retaining talent as the most important factor in decision making. 

Over the past several years, plan sponsors have faced a global pandemic, rising healthcare costs, economic uncertainty, shifting employee expectations and now rising tariffs / trade wars. While "attracting and retaining talent" has long been a key priority, the 2025 Lockton National Benefits Survey highlights a notable shift: "reducing costs" has now become the top factor in benefits decision-making.
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Despite this shift, many plan sponsors have not yet taken significant steps to lower costs. While some are beginning to optimize their plans, most are prioritizing cost-management strategies that minimize disruption rather than implementing more impactful changes. The challenge lies in balancing the need to reduce costs with the pressure to meet employees’ expectations for benefits — plan sponsors remain cautious about changes that could disrupt their workforce or be seen as not meeting members’ perceived needs. Continuing to delay meaningful action, however, could make it more difficult to achieve cost savings, ultimately leading to tougher decisions down the line.

All of this is happening amid a growing spotlight on plan sponsors to meet their fiduciary responsibilities in managing benefits plans. As with retirement plans, employers have an opportunity to educate themselves on their fiduciary duties and take proactive steps to document how they are fulfilling these obligations.

Password for accessing the survey is Locktonbenefits2025

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Tuck Private Equity & Venture Capital Conference - 2025

2/13/2025

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Snow, sleet, freezing rain made the drive up 89 from Boston to Hanover longer and more stressful than I’d planned. Make a plan and God laughs. The effort, however, was worth it for it was another great Tuck PEVC Conference.  Lockton was once again a sponsor. Bobby Steinsdorfer D’07 and I were in attendance as well as Mach Millett, our Alternative Investment Leader and CINO. Mach participated on the “Nuts & Bolts – The Broader Private Equity Ecosystem” panel.

The event kicked off with dinner at The Inn which included a fireside chat Marni Payne D’98, Managing Director at Berkshire Group and Professor Josh Lewis, Executive Advisor for Tuck CPEVC. Marni is focused on the consumer market in which it is hard to gain share of voice and share of eyeballs due to the fickleness of the changing consumer. They covered a wide swath of topics including fads vs. trends, best days and worst days in PE and what makes Berkshire Group different. I appreciated her discussion of alignment with the founder / management team as the formula for growth, scale and success. The business is not about “the chase” but focused on “the marriage”.

Pine at the Hanover Inn was busy after dinner, and I decided it was best for this 88 to hit the rack. It was a good decision as I was able to get in a 7.5 hike around campus before the event kicked off on Friday. Campus was quiet and beautiful with a fresh coat of snow. The Building & Grounds crew was clearing the ice at Occum Pond for some Winter Carnival skating and a handful of houses on Webster Ave. were forming the foundations of snow sculptures.

The day started with another fireside chat with Jeffrey Crisan D’95 and Jamie Havran T’25, Conference Co-Chair, & PE/VC Fellow. Once again, a wide range of topics was covered. Healthcare was the first discussed. Jeff feels that States as opposed to the Feds will be focusing on healthcare regulation over next 4 years. Mental health is an area of focus in healthcare fueled by HITECH, ACA, Mental Health Parity Act and demand accelerated through the pandemic. In technology, it’s best to think of the long-term benefits – think internet, SAS and now AI. He gave a wonderful illustration of evolving the podiatry business model into one that provides integrated care management to diabetes patients.

I attended several panels and a highlight was Energy & Climate featuring Jeph Shaw T’15, Sara Simonds T’03, James Socas, and Dave Russ - moderated by Jordan Swett, T’25. Some of the issues that resonated with me are
  • Wind and solar are growing rapidly (90% cost reduction in solar)
  • Most investments are going to red states (Texas is biggest renewable state)
  • Family offices are looking for climate investments from a social lens
  • Capital markets aren’t working efficiently for innovation investments like climate

Alas, I had Zoom call that ended my day at Tuck in the early afternoon. I did grab dinner at Murphy’s with some fellow Alums and then watched the Big Green beat Harvard in Men’s Hockey. All in all, a very successful day at Dartmouth.
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Other Key Takeaways:


𝗦𝗲𝗰𝗼𝗻𝗱𝗮𝗿𝘆 𝗠𝗮𝗿𝗸𝗲𝘁 𝗚𝗿𝗼𝘄𝘁𝗵 - liquidity solutions are expanding, and LPs are leveraging the secondary market more strategically than ever.

𝗡𝗼 𝗧𝗼𝗹𝗲𝗿𝗮𝗻𝗰𝗲 𝗳𝗼𝗿 𝗗𝗼𝘄𝗻𝘀𝗶𝗱𝗲 𝗥𝗶𝘀𝗸 - with higher interest rates and economic uncertainty, firms are laser-focused on resilient deal structures and downside protection.

𝗖𝗮𝗽𝗶𝘁𝗮𝗹 𝗥𝗮𝗶𝘀𝗶𝗻𝗴 𝗖𝗵𝗮𝗹𝗹𝗲𝗻𝗴𝗲𝘀 - differentiation is critical. Breaking through the noise in an era of information overload takes more than just a strong track record.

𝗣𝗼𝘀𝘁-𝗖𝗹𝗼𝘀𝗲 𝗩𝗮𝗹𝘂𝗲 𝗖𝗿𝗲𝗮𝘁𝗶𝗼𝗻 - the focus continues to shift from financial engineering to operational excellence, making real impact at the portfolio level.

𝗧𝗵𝗲 𝗣𝗼𝘄𝗲𝗿 𝗼𝗳 𝗦𝗮𝘆𝗶𝗻𝗴 𝗡𝗼 - disciplined investing isn't just about where capital is deployed; it's also about the deals and ideas that don't make the cut. Knowing when to pass is just as important as knowing when to commit.
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Several Tuck students looking at careers in PE or VC asked me “Smitty, how does insurance fit in with Private Equity and Venture Capital?” In short, our business help clients through fund level insurance, transactional liability and insurance due diligence. Given firms’ exposure to a variety of risks across different industries, specialized insurance products are needed both at the fund level and the portfolio company level. Risk appetite and approach to insurance depend on factors like firm culture, past relationships, deal structures, leverage, and exit strategies – to name a few. So here’s a primer on the topic and where Lockton works.

A. Fund-Level Insurance Needs (Protecting the Firm & Executives)
  • General Partner Liability Insurance (GP Liability): Protects the firm and its executives from lawsuits related to fund management, breaches of fiduciary duty, and investor disputes. Some firms are facing increased scrutiny from LPs and regulators.
  • Directors & Officers (D&O) Insurance: Covers the firm’s executives against claims from LPs, regulators, or other stakeholders. LPs may demand this coverage before committing capital.
  • Professional Indemnity (Errors & Omissions) Insurance: Protects against lawsuits arising from claims of mismanagement, negligence, or failure in investment strategies. LPs may also require this type of coverage.
  • Reps & Warranties (R&W) Insurance: Used in M&A deals to cover breaches of reps and warranties made by sellers, reducing escrow requirements. Sometimes R&W allows deals to close faster and with less negotiation over escrows and indemnities.
  • Cyber Liability Insurance: Protects against data breaches and cyberattacks affecting sensitive deal-related information. Firms handle sensitive financial and personal data, making them prime cyberattack targets.
B. Portfolio Company Insurance Needs (Protecting Acquired Businesses)
  • Property & Casualty (P&C) Insurance: Covers physical assets, business interruption, and general liability. Some lenders and investors require P&C coverage as part of financing agreements.
  • Management Liability (D&O, EPLI, Fiduciary): Covers executives of portfolio companies against lawsuits related to governance and employment practices.  These protections are becoming increasingly essential for retaining and attracting top executive talent.
  • Cyber & Data Breach Insurance: Protects against financial, reputational and operational risks of cyberattacks. Data breaches are costly and operationally disruptive. Many portcos operate in sectors with sensitive data (e.g., healthcare, fintech).
  • Workers’ Compensation & Employee Benefits Liability: Ensures compliance and protection against people-related risks. Workers’ Comp and Benefits (ACA) are not only legally required coverages but can assist in increasing productivity as well as talent attraction and retention.
  • Trade Credit & Political Risk Insurance: Helps mitigate risks in global operations, especially in emerging markets. Important for global expansion and risk mitigation in emerging markets.
  • Transactional Risk Insurance (e.g., Tax Liability, Contingent Liability) Covers unexpected tax assessments or legal liabilities discovered post-acquisition. Helps firms avoid costly surprises after closing deals.
C. Why Some Firms Look To Avoid Insurance
  • Cost Considerations (“It costs too much”): Some firms may view insurance premiums as an unnecessary expense, preferring to self-insure. Your broker should be well versed in your business to market possible coverages to help you determine whether the protection is worth the cost. Also, self-insuring can be more expensive in the long run. Reps & Warranties insurance, for example, can reduce escrow needs and improve capital efficiency.
  • Risk Tolerance (“We just don’t see the risk”): Some firms, usually those with well-diversified portfolios, may prefer retaining risk rather than paying for coverage. While it was Teddy Roosevelt that said, “Comparison is the thief of joy”, we have plenty of case studies of recent lawsuits, regulatory fines, or unexpected claims affecting firms that may help firms better see the risks.
  • Alternative Risk Transfer Mechanisms: Firms may use captive insurance companies or structured finance solutions instead of traditional insurance. We have lots of expertise and dedicated teams to help assess whether a captive makes sense and then how to implement and operationalize the strategy.
Insurance, done properly, is an efficient use of capital and delivers ROI.
Insurance can a tool to unlock capital, facilitate exits, and reduce deal risks. Well-structured insurance programs make portfolio companies more attractive at exit.
Your broker should understand the specific risks of your portfolio industries (e.g., healthcare, manufacturing, tech) and offer customized solutions.
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Survey says!...Benefit priorities are changing

6/4/2024

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As employers plan their 2025 benefits strategy, attracting and retaining talent and managing costs will both continue to be factors. The rise in healthcare costs means health plan sponsors will need to optimize their benefits plans to continue to be able to invest in attraction and retention. 

Over the last several years, the job market has been increasingly competitive and a key challenge facing many employers was how to attract and retain talent. To do so, many employers offered more attractive benefits packages to their people.

In the last year, the gap has narrowed between plan sponsors that rank attracting and retaining talent as the top priority in making benefits decisions and those who rank reducing costs as the top priority. Broad economic factors, including healthcare costs, inflation, global economic uncertainty have shifted employers’ focus. And healthcare cost is expected to rise again next year, under current market conditions, at an average rate of 6 to 8%.  

The 2024 Lockton National Benefits Survey data shows that while attracting and retaining talent is still highly important for plan sponsors, many employers indicated a competing priority — optimizing the cost of their benefits plan.

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​The 2024 Lockton National Benefits Survey features responses from 1,611 employers across the U.S. The employers represent a variety of industries, group sizes and ownership structures. Their responses reflect their different philosophies on how to attract and retain talent while managing the cost of their health and welfare benefits. 

Here is the Insights Report
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J&J & ERISA Fiduciary Responsibilities Webcast

3/6/2024

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A class action lawsuit was just filed against drug manufacturer Johnson & Johnson (J&J) in its capacity as an employer and plan sponsor.

The suit alleges that J&J breached its fiduciary duties by not taking proper measures to ensure its plan costs were reasonable as well as failing to exercise prudence in selecting its pharmacy benefit manager (PBM) and agreeing to undesirable contract terms. Specifically, the suit accuses J&J of mismanaging its employees’ drug benefits, resulting in employees significantly overpaying for certain drugs. 
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This lawsuit is an example of the recent uptick in impending lawsuits regarding compliance with recent transparency rules, reinforcing the need for ERISA fiduciary governance.

To help navigate these responsibilities, Lockton held webcast that walked through the key steps of proper fiduciary governance for employers. Click here for a replay of the webcast
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We have also created a Fiduciary Governance Toolkit to help ensure clients are well-versed on and are meeting their fiduciary duties. You can request a copy of the kit by clicking the link.

The Lockton Fiduciary Governance Toolkit includes:
  • A roadmap for establishing a health and welfare plan committee to formalize plan decision-making.
  • A checklist of key plan administrative functions that welfare benefit plan fiduciaries are responsible for managing.
  • Sample policies to address common and uncommon situations.
  • Sample welfare plan governance committee minutes to illustrate how to document prudent fiduciary processes to avoid big headaches later.

If you have questions or would like to speak with one of Lockton's Compliance attorneys, please reach out at [email protected] or 617-840-4515
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NEEBC's First Oncology Symposium

2/29/2024

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On February 15th, NEEBC orchestrated the region's first-ever employer focused Oncology Symposium, hosted at the Dana-Farber Cancer Institute in their Jimmy Fund Auditorium. The sold out event provided employers actionable insights to promote early detection and treatment, reduce oncology costs and how to best support employees, families and caregivers on their cancer journeys.

Leading experts discussed how organizations navigate the complex world of oncology care and focus on the ever-evolving world of oncology benefits:
  • New innovations in cancer prevention and early detection
  • How concordant care leads to better outcomes
  • The impact of social determinants of health on cancer treatments and follow up care
  • How to design a benefit plan to drive maximum value and managing costs 

​As cancer rates continue to rise, it’s important to remember that employees are increasingly concerned about cancer. This event was a learning opportunity for employers to increase understanding so that they can make a difference in cancer care for their workforce. 

Some of the survey feedback on the event was:
  • “Took away both long-term goals and ideas, as well as immediate, actionable items.”
  • “One of my top 3 NEEBC events ever!”
  • “Important topic done within an excellent session.”
  • “This was fantastic!”
  • “Great speakers and moderators.”
  • “Eye opening!”
  • “The balance, variety of perspectives, and ‘art & science’ of it all was just wonderful.”
  • “Excellent storytelling throughout.”
  • “Extremely informative for employers on how to support employees’ needs and challenges.”
  • “I literally didn’t want to leave.”

Some key takeaways for the Symposium are

The Critical Importance of Early Detection in Cancer Treatment
The discussion underscored the stark difference in survivability rates between early and late-stage cancer diagnoses, highlighting colon cancer as a case study where Stage 1 survival rates are at 91%, compared to only 13-14% for Stage 4. The panel noted that currently, only four types of cancers have approved and reliable screenings (colon, breast, cervical, and lung), leaving a significant gap as 72% of cancers do not have early detection tests. Further discussion centered on emerging technologies, like DNA-based blood and urine tests, that aim to fill this gap, offering hope for early detection across more types of cancer. The discussion around the FDA's breakthrough designation for Grail and the focus on high specificity to reduce false positives in testing are part of the efforts to improve early detection.

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Tuck Center for Private Equity & Venture Capital 2024 Conference

2/9/2024

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The February sun was shining, temperatures in the mid-forties as I arrived at the Hanover Inn. Back in town for the 2024 Tuck Center for Private Equity and Venture Capital Conference. My midday arrival allowed me to take a few laps around Occum Pond and the campus. Sadly, most of the snow had melted and the prospects for Carnival ice sculptures were dim. I’m sure the students were ready to revel in their long winter weekend. I know I did “back in the day”.
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The conference kicked off with a reception and dinner at The Inn featuring an hour-long interview of Silver Lake Partners co-founder, Jim Davidson, by Tuck Dean, Matthew Slaughter. Jim was a last-minute pinch hit and I thoroughly enjoyed the interview and discussion which included topics such as
  • Build an opinion through research, reading, intuition and creative thinking. Share that opinion and invest toward it. Invest in a theme that you are passionate about (Jim does not have a lack of opinions and guess his track record speaks for itself.)
  • Near the anniversary of SVB, small banks hold a substantial amount of commercial real estate debt and this is an area of concern.
  • WFH is bad for career entries and development (Google programmers were found to be 180% more productive in Mountain View than at home) Collaboration matters and so does building personal networks.
  • AI will take out 20-30% of back-office processing and we’re just beginning to understand how it will change the world (think Internet in the early 90’s)
  • People misunderstand the energy sector. Movement to clean energy is happening and it will take longer to move off oil and gas. Venezuela is currently the country with the largest proven oil reserves in the world, with an estimated 300 billion barrels of oil.
  • Geopolitics and global trade dynamics are changing. US, Mexico LATAM and South America are seeing the benefits of onshoring / friend-shoring 

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    Mike Smith - trying to put my history degree to good use through research and writing .  Mom would be proud but she still wanted me to study business.

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