Self-insured employers and their brokers fund every claim the carrier turns down; yet they have no infrastructure to forecast exposure, intervene before deductibles breach, or defend renewal increases with hard data. Continuum RiskFlow flips the table: the same analytics the carrier uses, in your hands first.
Stop-loss carriers report quarterly. High-cost claimants routinely surpass 50% of their specific deductible before anyone on your team is alerted.
Carriers price next year's premium from this year's worst claims. Renewal increases of 15–40% land on the plan sponsor with no data-backed counterargument.
A high-risk individual gets lased; your group absorbs a 2–4x larger specific deductible for that member, with no advance forecast.
Specialty drug spend routinely hits 25–40% of pharmacy PMPM. Aggregate corridor burn reveals itself at year-end, after months of trending.
Your only view of a client's risk is the carrier's quarterly report; no drilldowns, no scenario modeling, no independent analytics to challenge renewal narratives.
Tracking 25+ employer groups across 8–12 Excel workbooks. Each renewal window eats days of consolidated spreadsheet scrubbing.
You learn about high-cost claimants during renewal; by then, 12 months of trajectory has already baked into the rate.
Performance fees and case-management savings are hard to justify without logged interventions, captured savings, and measurable risk reduction.
Stop-loss insurance is your safety net; but carriers price renewal based on yesterday's claims. RiskFlow gives you tomorrow's forecast so you can intervene before the underwriter does, protecting your self-insured plan from aggressive rate hikes and surprise lasering.
You fund your own claims. Your stop-loss carrier sets your renewal premium based on what they see across your entire population. RiskFlow gives you the same analytical toolkit the carrier uses; so you can negotiate from data, not from guesswork.
See exactly where every high-cost claimant stands against their specific deductible; daily, not quarterly.
Forecast Q3 stop-loss exposure based on current claim velocity so you can budget and plan interventions.
AI-generated renewal narratives with data-backed counterarguments to carrier increase proposals.
Specialty drug tracking across your population; catch cost spikes before they hit your aggregate corridor.
Clinical action logging and savings measurement for high-risk claimants; prove the ROI of your wellness programs.
AVG RENEWAL SAVINGS
8–15%
On stop-loss premium
Claimant Risk Visibility
100%
Of members above 50% ded.
INTERVENTION SAVINGS
$35K–
Per completed intervention
TIME TO INSIGHT
< 5 min
From upload to dashboard
Your clients trust you to manage their stop-loss renewal. You currently rely on carrier reports and spreadsheet audits. RiskFlow gives you an independent, AI-powered analytics platform that makes you the indispensable strategic partner; not just the policy placer.
One dashboard across all employer groups; heat maps, trend lines, and risk tier distribution at a glance.
LLM-generated renewal strategies with risk assessments, communication points, and counter-negotiation data.
Threshold-based notifications for deductible breaches, aggregate corridor burn, and claim velocity spikes.
Track contract basis, laser provisions, and terminal liability across every client's stop-loss policy.
Demonstrate measurable savings to justify performance-based compensation models with clients.
CLIENT RETENTION
+40%
With RiskFlow analytics
GROUPS PER MANAGER
25–
With AI-assisted monitoring
RENEWAL NEGOTIATION WIN
72%
Of carrier increases reduced
PLATFORM ROI
6x
Revenue vs platform cost
AI-powered analysis of claims, pharmacy, and clinical data. Scores every claimant and employer group 0–100.
Learn more16 alert types from deductible thresholds to aggregate corridor warnings. Assigned to account managers.
Learn morePortfolio heat maps, trend analytics, exposure distribution, and quarterly risk projections.
Learn moreLog clinical actions, track milestones, measure savings. Full workflow from identification to outcome.
Learn moreSpecialty drug spend by employer and diagnosis. PDMP integration and drug interaction history per claimant.
Learn moreAI-generated executive summaries with risk assessments, intervention impact, and negotiation strategy.
Learn moreStop-loss policy configuration: deductibles, contract basis, lasering, terminal liability. Plan-year aware.
Learn moreCompare loss ratios, large claimant counts, and pharmacy spend across your portfolio.
Learn moreMonthly claims feed via secure SFTP or API integration. Standard 837/835 formats accepted.
Risk scoring engine runs against claims, pharmacy, and policy data. Scores every member and employer.
Executive command center updates automatically. Threshold alerts sent to assigned account managers.
Clinical team acts on high-risk claimants. AI-generated renewal narrative ready 30 days before renewal.