Gene Therapy Stop-Loss

The clinical promise of gene and genetically modified cellular therapies is hard to overstate. These breakthrough treatments have the potential to save lives, reduce much suffering, and offset future health care costs. But the initial impact of an unexpected high-cost claim for even one of these treatments can be financially disruptive. 

Our Gene Therapy Stop-Loss solution can help smooth the actuarial risk. This robust and flexible insurance product offers two options for one-time infusion therapies:  Payors can choose to cover only FDA-approved products at the start of the stop-loss policy year, or to also include new therapies that gain approval during the policy year.

Both options have other standard features that enhance the financial risk protection, including:

• No exclusions or limitations on the amount covered for each member for FDA-approved or pipeline gene therapy drugs above the individual stop-loss limit
• The exclusion of the cost of a gene therapy claim from future renewal calculations