Solutions, Health, Stop-loss

A claim about another claim

A stop-loss claim is a claim about another claim: one catastrophic medical expense, with disclosure, lasering and TPA-supplied detail behind it. Owl reads the medical record, the disclosure, the eligibility file and the TPA pay file at once, walks the contract, and tells you whether it breaches.

Recovery curve, Claimant cost trajectory, 24-month policy0 → 365 days
This file, day 226P50 RTW, day 200

$1.45M

Cumulative paid, day 226

$1.0M spec

Specific deductible attachment

$450K

Stop-loss recoverable day-one

03A real claim, walked end to end

One claimant: $1.45M paid, day 226, recoverability answered in 1.6s.

Anonymized composite. Self-insured employer, $1.0M spec, $1.5M agg corridor, claimant 6F with relapsed leukemia and CAR-T therapy.

Claim #
SL-2025-00214
Spec / agg
$1.0M / 125%
Claimant
6F, CAR-T, C91.0
Paid YTD
$1.45M
Recoverable
$450K (day-one)
OwlVision
What it read
Stop-loss policy + endorsements
64 pp
Read, contract walked
Disclosure statement (post-bind)
18 pp
Read, compared to chart
TPA paid-claim ledger
412 pp
Read, re-tested vs. policy
Underlying medical record
1240 pp
Read, CAR-T arc indexed
Eligibility + COBRA file
22 pp
Read, coverage validated
Structured extraction
Claimant 6F; Dx C91.0 (relapsed B-ALL); CAR-T therapy 2024-11; cumulative paid $1.45M (day 226); spec $1.0M reached day 198; agg corridor $1.5M not reached. No disclosure-omission pattern detected, no exclusion fired, claim recoverable.
OwlSignal
What the world said about the claimant

External data only. None of this lives in your CMS. Owl gathered it from public records, professional networks, registries and the open web, then resolved it to this claimant.

COH-02
Cohort trajectory, within band

Owl’s CAR-T cohort cost-trajectory model (n=4,200 claimants across self-insured plans) places this claimant at the 56th percentile for cumulative paid by month 7 post-CAR-T. Within reasonable band; no TPA mispayment pattern detected.

Owl CAR-T cost cohortCMS DRG benchmarksAcademyHealth oncology cost reference
DSC-04
Disclosure consistency check

Disclosure named "leukemia, in remission, last treatment 2022" with no expected high-cost therapies. Chart shows surveillance imaging in 2023 with rising MRD that was not disclosed. Material? Likely no, because the policy is post-bind and the relapse occurred after policy effective. But flag for underwriter for laser-renewal decision.

Disclosure statement post-bindUnderlying chart (oncology)Policy effective 2024-01-01
POL-12
No exclusion fired

Policy exclusions checked: experimental/investigational (CAR-T is FDA-approved for this indication, exclusion does not fire), congenital (does not fire), TPA-error (no error pattern), eligibility (member fully eligible).

Policy §4 exclusionsFDA approval list 2024Eligibility + COBRA file
PRV-09
CAR-T center, in-network NCI-designated

Treating institution is an NCI-designated comprehensive cancer center, in-network with the underlying medical plan. No center-quality or unbundling pattern detected.

NCI-designated center registryNetwork statusCMS Care Compare
OwlAssist
What it answered
Examiner asked
Is this claim recoverable today, and how much?
Owl answered in 1.6s

Yes, recoverable. The claimant breached the $1.0M specific deductible on day 198 of the policy year. Cumulative paid is $1.45M as of day 226. Recoverable today is $450K (cumulative paid above spec). The aggregate corridor is not in play; total plan-paid sits below 125% of expected. No exclusion fires (CAR-T is FDA-approved for relapsed B-ALL), no eligibility defect, and the disclosure-versus-chart comparison shows MRD surveillance not disclosed, but the relapse occurred after policy effective, so it is non-material to coverage. Pay the claim and route the disclosure note to renewal underwriting for the laser conversation.

Policy §3 spec deductibleTPA ledger 2024-12 → 2025-08FDA approval list 2024Disclosure statement vs. chart 2023-2024
Examiner asked
Should we laser this claimant at renewal?
Owl answered in 1.4s

Lean yes, but laser at $250K, not exclude. Relapse + CAR-T claimants run a 38% second-relapse rate within 24 months per the cohort trajectory model, with average second-relapse spend of $620K. A $250K laser captures expected continuing surveillance and any second-relapse spend up to that band, while keeping the placement competitive. Memo drafted with cohort tables and prior-treatment timeline.

Owl CAR-T cohort 24-month outcomesRenewal pricing playbookDisclosure statementChart oncology 2022 → 2024
04OwlSignal external data

What the world says about your Stop-loss claimants, none of which lives in your CMS.

Internal claim data is half the picture: it tells you what the claimant told you. OwlSignal continuously gathers external data (public records, professional and corporate registries, court dockets, social and open web) and matches it back to the claimant. These are the families that move the needle on Stop-loss.

COHCondition-Cost Cohorts

Owl’s cross-payer cohort cost-trajectory models for the catastrophic conditions that drive stop-loss exposure: CAR-T, BMT, ECMO, transplant, gene therapy, hemophilia, premature neonate.

Owl cross-payer cost cohortsCMS DRG benchmarksAcademyHealth, NICE references
DSCDisclosure & Eligibility

Disclosure statements compared element-by-element to the underlying chart. Eligibility files, COBRA records, and certificate-of-coverage tested against the claimant’s active dates.

Disclosure docs (post-bind)Eligibility filesCOBRA records
CXMCross-Payer Medical History

Cross-carrier prior medical history, where law and consent allow, to surface prior conditions, prior procedures and prior failed therapies relevant to material-disclosure analysis.

Owl cross-carrier history graphDatavantEpic Care EverywhereCommonWell + Carequality
PRVProvider & Center Quality

NCI-designated centers, transplant program registries, OIG LEIE, state medical board sanctions, and Owl’s cross-payer outcomes graph for catastrophic-care providers.

NCI-designated registryOIG LEIE, SAM.govCMS transplant outcomesOwl cross-payer outcomes
POLPolicy & Contract Constructs

Stop-loss policy, endorsements, lasers, exclusions, run-in / run-out, eligibility waivers: read once, walked on every breach decision.

Policy + endorsementsLasers + exclusions scheduleRun-in / run-out provisions
TPATPA Ledger Integrity

TPA paid-claim ledger re-tested against policy: timely-pay, FFS coding, unbundling, balance-bill exposure, claim age. The integrity check that decides what is and isn’t reimbursable.

TPA paid-claim ledgerTPA fee scheduleOwl unbundling pattern library
Refreshed daily, matched by identity-resolution, every observation cited to its source.
05What changes

Numbers from MGUs and reinsurers running Owl on stop-loss in production.

MetricWithout OwlWith Owl
Files read end-to-end24%100%
Cycle time, breach decision38 days6 days
TPA mispay leakage / large claim$84,000$11,000
Disclosure-defect detection17%78%
Laser-renewal decision supportmanualauto, per claimant
Reinsurer-claim cost, per file$2,400$420
Source: rolling 12-month average across 4 MGUs + 2 reinsurers, spec + agg claims, n = 6,800 large claimants.

Built for the regulatory shape of Stop-loss.

07Integrations

Lives where your Stop-loss files live.

Stop-loss platforms

Sun Life, Tokio Marine HCC, Symetra, QBE, in-house

TPA platforms

WLT, Trizetto QicLink, LuminX, Plexis, in-house

EHR / records

Epic, Cerner, MRO, Verisma, Datavant

Disclosure intake

Box, OnBase, ImageRight, email parser

Cohort + cost references

CMS DRG, NCCN cost, Milliman MARA

Identity & SSO

Okta, Azure AD, PingFederate, SAML, SCIM

08Get started

Bring us a quarter of large claims. We’ll show you the breach math on day one.

Two-week pilot. Your large-claim stream, your tenant, your policy. We measure cycle time, leakage capture, disclosure-defect detection and laser-renewal support against your own ground truth.