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🎯 '''Lasering''' is an [[Definition:Underwriting | underwriting]] practice in which a [[Definition:Reinsurer | reinsurer]] or [[Definition:Stop-loss insurance | stop-loss carrier]] isolates a specific individual, risk, or known [[Definition:Claim | claim]] from the broader coverage provided under a contract and applies a separate, higher [[Definition:Deductible | deductible]], [[Definition:Attachment point | attachment point]], or outright [[Definition:Exclusion | exclusion]] to that particular exposure. The term originates from the idea of using a laser to single out one target with precision rather than applying a blanket adjustment to the entire account. Lasering is most commonly encountered in [[Definition:Group health insurance | group health]] [[Definition:Stop-loss insurance | stop-loss]] reinsurance and [[Definition:Excess of loss reinsurance | excess-of-loss]] programs, but it can appear in other lines where individual risk concentrations are identifiable at renewal.

🔍 In practice, lasering typically occurs at [[Definition:Renewal | renewal]] time. The stop-loss carrier reviews the [[Definition:Claims experience | claims experience]] of the underlying group and identifies members with ongoing [[Definition:High-cost claimant | high-cost conditions]] — such as organ transplants, cancer treatment, or hemophilia — whose expected future claims are virtually certain to breach the standard [[Definition:Specific stop-loss | specific deductible]]. Rather than raising the [[Definition:Premium | premium]] for the entire group to absorb these known costs, the carrier "lasers" those individuals by setting their specific deductible substantially higher — sometimes at levels that effectively eliminate any meaningful reimbursement for that member's claims. Alternatively, the carrier may exclude the individual altogether or offer a separate [[Definition:Premium rate | rated]] attachment. The [[Definition:Policyholder | employer]] or plan sponsor is then left to decide whether to absorb the higher retention on those lasered members, negotiate with a competing carrier, or restructure the plan.

⚖️ While lasering allows carriers to price more accurately for known exposures and avoid subsidizing predictable losses through pooled rates, it is controversial because it shifts the financial burden of the sickest individuals back onto the employer. Critics argue that it undermines the risk-pooling function that [[Definition:Insurance | insurance]] is designed to serve. Some states have introduced regulations limiting or prohibiting lasering in the [[Definition:Small group market | small group market]], though it remains widespread in the [[Definition:Large group market | large group]] and [[Definition:Self-funded plan | self-funded]] segments where [[Definition:Employee Retirement Income Security Act (ERISA) | ERISA]] preemption limits state regulatory reach. For [[Definition:Insurance broker | brokers]] advising self-funded employers, navigating lasering provisions at renewal is a critical part of the [[Definition:Benefits consulting | benefits consulting]] process — and an area where transparent communication about cost allocation can make or break the client relationship.

'''Related concepts:'''
{{Div col|colwidth=20em}}
* [[Definition:Stop-loss insurance]]
* [[Definition:Specific stop-loss]]
* [[Definition:Self-funded plan]]
* [[Definition:Attachment point]]
* [[Definition:High-cost claimant]]
* [[Definition:Exclusion]]
{{Div col end}}

Definition:Lasering - Revision history

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