Stop-Loss Intelligence • Exposure Monitoring • Intervention Readiness
| Employer | Risk Status | Covered Lives | Claims YTD | Projected | PMPM | Loss Ratio | Aggregate | Large Claimants | ≥50% DED. | ≥75% DED. | Exceeded | Renewal Risk | Action |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Midwest Regional Health System | Critical | 3,400 | $18.2M | $24.8M | $730 | 124% | 88% | 6 | 18 | 11 | 6 | 88 | URGENT: Oncology case management, specialty pharmacy review, COE referral |
| Acme Manufacturing Corp | Elevated | 2,800 | $9.6M | $13.2M | $476 | 91% | 64% | 3 | 12 | 5 | 2 | 68 | Acme Manufacturing Corp is approaching aggregate corridor — initiate case management review |
| Pacific Tech Solutions | Watch | 2,100 | $4.2M | $5.8M | $337 | 72% | 41% | 1 | 6 | 2 | 0 | 42 | Monitor — no urgent action needed, tracking pharmacy trend |
| Greenfield Logistics LLC | Low Risk | 2,970 | $3.4M | $4.1M | $284 | 58% | 28% | 1 | 3 | 1 | 0 | 22 | On track — routine monitoring |