The Risk Tower
Where your risk ends & the carrier's begins
You pay (retained claims)
Carrier covers (excess)
Aggregate corridor — your risk margin
Specific Stop-Loss
Individual claimants vs. your deductible
Each large claimant in this scenario. Everything below the specific deductible line is yours; the carrier reimburses the excess. Lasered members carry a raised, individual deductible.
Employer pays (to deductible)
Carrier specific reimbursement
⚡ Lasered claimant
Sensitivity Analysis
Actual vs. budgeted spend, all three scenarios
Your all-in employer cost in each scenario against your budget and your max exposure. The gold overflow is the cost above budget that your aggregate stop-loss absorbs before it reaches the ceiling.
Retained claims
Premium + admin (fixed)
Over-budget overflow
Attachment Sensitivity
How the specific deductible moves your exposure
Hold everything else fixed and slide the specific deductible across its range. A higher deductible saves premium in a good year but widens your downside — the gold band is the spread between an expected and a catastrophic year at each setting. Your current point is marked.
Self-Funded vs. Fully-Insured
What you'd pay either way
A fully-insured premium is flat — you pay the carrier's markup every year regardless of claims. Self-funding lets you keep the savings in good years, with stop-loss capping the bad ones.
Total Cost of Risk
Your all-in cost — expected year
Every dollar of risk you carry in the selected scenario: claims you retain, the stop-loss premium that caps them, and plan administration.
The Bottom Line
Your maximum exposure this year
$4.9M
Illustrative model for strategy discussion only — premium factors, capture rates, and scenario loads are calibrated estimates, not a quote or actuarial certification. Final terms depend on carrier underwriting, census, and disclosure. Prepared by Tess McCoy, CEBS® CSFS® · Hotchkiss Insurance.