BCS Financial Introduces Employer Group Gene Therapy Stop Loss

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As gene therapies become more popular, payers are looking for new ways to handle these treatments. BCS Financial announced a new stop loss product for small and mid-sized employer groups that protects against gene therapy costs. The product will work alongside traditional stop loss coverage.

In a press release, BCS head of large claims solutions Mehb Koja explained, “Gene therapies are changing modern medicine, and they are also changing the self-funded insurance market. With treatments ranging $2M to $4M, it's going to be a challenge for many self-funded employer groups to finance these costs within their traditional stop loss policies. That's why we've created Stop Loss GTS–to help fill a gap in the market and provide additional protection for employers."

Khoja continued, “Our goal is to help alleviate the unexpected burden of these expenses for self-insured employers and health plans.”

Due to the unique and complex nature of gene therapies, costs can unexpectedly rise, causing issues for payers.

"We've had solutions in the market since 2019 when the first gene therapies were FDA approved,” Khoja said, “and have introduced new products as additional therapies have hit the market. As the gene therapy pipeline continues to grow, BCS will continue to develop new and innovative products and solutions alongside with it."

In June, BCS announced the addition of its Gene Therapy Rider, which can cover 100% of the policy face amount for covered diseases treated with gene therapies.²

In a press release issued at the time, BCS head of ancillary benefits Drew Neslin said, “BCS is continually innovating our ancillary and voluntary products to better support the market and our customers. The price of gene therapies limits their accessibility for many, and our hope is that the Gene Therapy Rider on EssentialCare Critical Illness can help increase affordability and access to care for these life-changing treatments."

In November of last year, BCS added its first stop loss and reinsurance offerings for gene therapies.³

At the time, Peter Costello, BCS president and CEO, said, “Gene therapies offer the promise of potential cures, but with treatment costs ranging from $2M to $4M payers and self-insured employers will be challenged to finance these unprecedented costs. At BCS, we are focused on finding new ways to help health plans, employers, and ultimately insureds finance and utilize these costly treatments as part of our mission to improve affordability and access to care."

In the same press release, Khoja said, “The gene therapy pipeline is experiencing rapid growth, and BCS is growing and developing right alongside it with new and innovative products and solutions. These are remarkable treatments, and our goal is to help alleviate the unexpected burden of these expenses for self-insured employers and health plans."

Sources

1. BCS Financial Launches Gene Therapy Stop Loss for Employer Groups. BCS Financial. October 3, 2024. https://www.prnewswire.com/news-releases/bcs-financial-launches-gene-therapy-stop-loss-for-employer-groups-302266906.html
2. Innovative Critical Illness Policy Rider Provides Financial Support for Gene Therapies. BCS Financial. June 18, 2024. Accessed October 3, 2024. https://www.prnewswire.com/news-releases/innovative-critical-illness-policy-rider-provides-financial-support-for-gene-therapies-302175475.html
3. BCS Financial Leading the Way with New Gene Therapy Reinsurance Solutions. BCS Financial. November 28, 2023. Accessed October 3, 2024. https://www.prnewswire.com/news-releases/bcs-financial-leading-the-way-with-new-gene-therapy-reinsurance-solutions-301999319.html