What's Happening?
QBE North America has published its 2025 Accident and Health Market Report, highlighting trends impacting self-funded healthcare plans. The report emphasizes the growing importance of medical stop-loss coverage due to increasing claims frequency and severity. Key findings include rising costs associated with cancer, circulatory diseases, and premature births. The report also discusses the impact of societal health factors on claims, noting an increase in cancer diagnoses linked to lifestyle and environmental factors. QBE has expanded its offerings to Taft-Hartley and multi-employer health plans, which are noted for their strong governance and higher healthcare access among members.
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Why It's Important?
The report underscores the challenges faced by self-funded healthcare plans in managing rising claims costs, particularly in the context of chronic diseases and specialty pharmaceuticals. Employers and brokers are advised to focus on cost-effective solutions and plan enhancements to mitigate these trends. The findings highlight the need for increased education on lifestyle factors contributing to health issues, which could influence future healthcare strategies and policy decisions. The expansion into Taft-Hartley plans suggests a strategic move by QBE to tap into a market with unique management capabilities and higher healthcare engagement.
What's Next?
Employers and brokers are encouraged to explore transparent vendor partnerships and implement utilization management strategies to control costs. The report suggests that slight modifications to specific deductibles can help mitigate renewal increases. As societal health factors continue to impact claims, there may be increased focus on preventive care and lifestyle education. QBE's expansion into union plans could lead to further innovations in plan management and cost control.
Beyond the Headlines
The report highlights the ethical and societal implications of healthcare access disparities, particularly in relation to lifestyle and environmental factors driving health trends. The focus on preventive care and lifestyle education could lead to long-term shifts in public health policy and employer strategies.
