Top 20 conditions driving the highest self-insured claims

Becker's Healthcare May 16, 2023
Jakob Emerson

Malignant neoplasms accounted for the most expensive claims for self-insured employers in 2022 and during the last four years, according to a May report from Sun Life, a life and health insurance provider.

Sun Life analyzed four years of claims from 2019 through 2022, representing more than 55,000 members, $5.5B in total reimbursements, and $12.2B in total cost. The data set includes the full Sun Life. The top 10 conditions were found to be responsible for 71 percent of all stop-loss claims.

Highest-cost claim conditions based on stop-loss claim reimbursements:

1. Malignant Neoplasm
2022: $324.8 million
2019-2022: $1.13 billion

2. Leukemia, Lymphoma, Multiple Myeloma
2022: $115.2 million
2019-2022: $462.5 million

3. Cardiovascular
2022: $142.4 million
2019-2022: $443.8 million

4. Orthopedics/Musculoskeletal
2022:...

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