September 03, 2020

New Competition for Stop Loss Carriers

Verily, Alphabet/Google’s life sciences health care subsidiary, has partnered with Swiss Re to offer stop loss coverage to self-funded health plans (ERISA employer plans). This is a large segment/revenue stream for established managed care organizations (MCOs) like the large Blue Plans and entities like United Health, Aetna, Cigna, Humana and Centene. These MCOs depend on administrative services only (ASO), agreements with self-funded health plans for significant revenue, and as a part of those ASO agreements often provide “employer stop loss” coverage to these plans. The entry of Verily in this market, supported by Swiss Re, will put significant pressure on the MCOs to guard their markets and revenue which will increase the possibility of antitrust/unfair and deceptive trade practices claims in the industry.