Laser (Stop-Loss Laser)

A laser is a stop-loss provision that carves out a specific individual — usually a known high-claimant — with a higher specific deductible than the rest of the plan. If the plan's normal specific deductible is $75,000 and one member has an active $400,000-per-year specialty drug regimen, the stop-loss carrier might "laser" that member at $250,000. The plan pays the first $250,000 for that person before stop-loss kicks in.

Lasers appear at renewal when the stop-loss carrier has claims history showing a specific member likely to exceed the deductible in the coming year. They're legal, common, and one of the biggest sources of self-funded plan surprises. A first-year self-funded employer may have priced the plan without knowing a laser was coming at renewal — and then face either a higher specific deductible for one person or a materially higher stop-loss premium to buy the laser off. "No new lasers" and "no laser at renewal" contract provisions cost more upfront but protect against this exact scenario.

The takeaway: when quoting stop-loss, always ask for "no new lasers" language and understand what the renewal disclosure requirements are. Getting lasered at renewal without protection can turn a good self-funded year into a painful one.