Malignant neoplasms accounted for the most expensive claims for self-insured employers in 2022 and during the last four years, according to a May report from Sun Life, a life and health insurance provider.
Sun Life analyzed four years of claims from 2019 through 2022, representing more than 55,000 members, $5.5B in total reimbursements, and $12.2B in total cost. The data set includes all of Sun Life's stop-loss data. The top 10 conditions were found to be responsible for 71 percent of all stop-loss claims.
Highest-cost claim conditions based on stop-loss claim reimbursements:
1. Malignant Neoplasm
2022: $324.8 million
2019-2022: $1.13 billion
2. Leukemia, Lymphoma, Multiple Myeloma
2022: $115.2 million
2019-2022: $462.5 million
3. Cardiovascular
2022: $142.4 million
2019-2022: $443.8 million
4. Orthopedics/Musculoskeletal
2022: $106 million
2019-2022: $338.8 million
5. Newborn/Infant Care
2022: $106 million
2019-2022: $338.1 million
6. Respiratory
2022: $69.4 million
2019-2022: $255.7 million
7. Sepsis
2022: $89.7 million
2019-2022: $240.4 million
8. Neurological
2022: $70 million
2019-2022: $236.4 million
9. Gastrointestinal
2022: $70.2 million
2019-2022: $231.8 million
10. Urinary/Renal
2022: $54.3 million
2019-2022: $220.6 million
11. Congenital Anomaly (structural)
2022: $43.5 million
2019-2022: $172.9 million
12. Physician Treatment
2022: $50.1 million
2019-2022: $164.9 million
13. COVID-19
2022: $52.8 million
2019-2022: $128.3 million
14. Transplant
2022: $17.9 million
2019-2022: $112.4 million
15. Cerebrovascular
2022: $25.7 million
2019-2022: $103.4 million
16. Mental and Behavioral Health
2022: $32. million
2019-2022: $103 million
17. Hemophilia/Bleeding
2022: $23.1 million
2019-2022: $99.9 million
18. Immune System
2022: $21.4 million
2019-2022: $87.9 million
19. Malnutrition
2022: $25.3 million
2019-2022: $85.8 million
20. Blood and Blood Forming Organs
2022: $21 million
2019-2022: $78.1 million