The Challenge of High-Cost Medical Claims
In 2024, employers faced a significant challenge with a 29% increase in $1 million medical stop-loss claims compared to 2023, according to Sun Life’s analysis. Claims exceeding $3 million rose by 47%, with the highest single claim reaching $12.7 million for a birth defect. These jumbo claims, often driven by cancer treatments (over 48% of costs with cardiovascular diseases), premature births, and costly specialty drugs like gene therapies, are putting pressure on self-funded employers. The stop-loss insurance market, valued at $35.5 billion in 2023 with an 11.9% growth rate from 2018 to 2023, is seeing premiums rise, with providers like Voya increasing rates by 21% or more for 2025. This trend, coupled with another massive projected increase in group market medical costs for 2026, underscores the need for effective cost-management strategies.
The Role of Preventive Care in Cost Management
Preventive care is a powerful tool for managing healthcare costs. The CDC notes that chronic diseases, such as heart disease and diabetes, account for 75% of U.S. healthcare spending, but clinical preventive strategies can reduce their incidence. For instance, early detection through screenings can prevent costly treatments, with studies suggesting potential savings of up to $45 billion annually through effective interventions like disease management. However, some argue that preventive care may increase short-term costs due to higher service utilization. Despite this, the long-term benefits of a healthier workforce are widely recognized, making preventive care a cornerstone of cost-effective health plans.
NARFA’s Solutions for Employers
The National Automotive, Roads, and Fuel Association (NARFA), with nearly a century of experience, offers robust solutions for employers in the automotive, roads, fuel, and for businesses with fleets of 5 or more vehicles. NARFA’s programs are designed to address rising healthcare costs while enhancing employee well-being.
NARFA’s strategy includes:
- Analyze YOUR claims data, not regional averages.
- Knowing your industry through nearly 100 years of experience
- Alternative funding solutions
- Group buying power
Health Insurance Plans with Preventive Care
NARFA’s health insurance plans, offered through the largest national carriers, are ACA-compliant, ensuring coverage for preventive services like annual physicals at no cost to employees. These plans, including PPOs, HSAs, and alternative funding options, leverage group buying power to provide competitive rates, helping employers save thousands annually while promoting early detection to reduce high-cost claims.
Promoting a Strong Safety Culture
NARFA emphasizes workplace safety through resources like the AICC Safety and Loss Control Manual, which supports employers in preventing injuries. Recent posts highlight safety practices, such as heat illness prevention and equipment handling, reducing workers’ compensation claims and associated medical costs. *can you link to some
Employee Assistance Programs (EAP)
NARFA’s EAP provides confidential support for issues like stress, depression, and substance abuse, accessible to members, their dependents, and employees on NARFA medical plans. Services include telehealth, counseling, and Narcan training, addressing mental health to prevent chronic conditions that drive up costs.
Group Buying Power and Additional Benefits
NARFA’s group buying power enables small and medium-sized businesses to access premium rates typically reserved for larger firms. Beyond health insurance, NARFA offers dental, vision, and voluntary benefits, creating a comprehensive package that supports employee health and retention.
Benefits of Partnering with NARFA
Partnering with NARFA offers multiple advantages:
- Cost Savings: Preventive care and safety initiatives can reduce claim frequency and severity, potentially lowering stop-loss premiums.
- Improved Employee Health: Comprehensive plans and available EAP foster a healthier workforce, reducing absenteeism and boosting productivity.
- Financial Stability: Competitive rates through group buying power ensure robust benefits without financial strain.
- Compliance and Support: NARFA provides HR and compliance support, helping employers navigate regulations (NARFA, 2025).
Key Statistics on Healthcare Costs
Metric | Details |
---|---|
$1M+ Claims in 2024 | 221 Per 1 Million covered employees, up 29% from 2023 |
$3M+ Claims in 2024 | 47, up 47% from 2023 |
Highest Single Claim in 2024 | $12.7M for a birth defect |
Stop-Loss Market Premiums | $35.5B in 2023, 11.9% growth from 2018-2023 |
Take Action with NARFA
With healthcare costs rising, NARFA’s programs offer a strategic solution. Visit NARFA to explore how NARFA can help your business manage costs and enhance employee health.
And, contact us today to get a quote and start saving money.
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