I've spent about 15 years working with self-funded accounts—first at a brokerage, then at a TPA, and now at XL Benefits where I focus exclusively on stop-loss. In that time, I've seen what separates smooth placements from difficult ones.
It usually comes down to data. Not just whether we have it, but whether we have enough of it to tell the full story.
The Efficiency Problem
Here's what happens when we market a case with incomplete information:
A carrier takes 10 days to return a quote. On day 8 or 9, they come back asking for additional data—prior year claims, PBM details, large claimant diagnoses. Now we're starting over. The timeline doubles. The broker looks unresponsive to their client. Everyone's frustrated.
More data upfront means faster, cleaner quotes. That's not complicated, but it's overlooked constantly.
When Incomplete Data Goes Seriously Wrong
I'm working on a case right now that illustrates the extreme version of this problem.
A group is currently in arbitration with their stop-loss carrier. The carrier issued a non-renewal and is pursuing the employer over a deficit exceeding $1 million. The allegation: the carrier didn't have all the data they needed during underwriting to price the risk accurately.
I don't know every detail of what happened. But the implication is that incomplete information at placement led to inadequate pricing, which led to catastrophic losses, which led to legal action.
That's the worst-case scenario. Most incomplete submissions just result in conservative quotes or slower timelines. But the stakes can be much higher than brokers realize.
We Can't Offer Solutions We Don't Know You Need
This is the part that frustrates me most.
Our team is good at creative problem-solving. We work with programs like Samaritan Fund to carve out high-cost members. We know which carriers offer gene therapy protections. We understand which specialty PBM arrangements can unlock additional discounts.
But we can only offer those solutions if we know the full picture.
I've had carriers come back after a case closed and say, "We wish we'd known that PBM program was in place—we would have offered a much better rate." By then it's too late. The case went somewhere else, and the broker's client missed out on savings because we didn't have one piece of information.
It's not that brokers are trying to hide things. Sometimes they're in a rush. Sometimes the TPA makes it hard to pull reports. Sometimes they just don't realize we need it.
But when we're missing context, we can't advocate as effectively. We're working with one hand tied behind our back.
Not All TPAs Make This Easy
This is worth mentioning: the quality of your TPA's reporting matters more than most people think.
Some TPAs can pull detailed claims data, large claimant reports, and monthly breakouts within 24 hours. Others take weeks—and even then, the data requires cleanup and multiple follow-ups before it's usable.
If your TPA is slow or provides poor-quality data, it affects your stop-loss quotes. Carriers can't price what they can't see. And if the data arrives late, you're compressing the marketing timeline and limiting your options.
We work with TPAs across the country and we know which ones make this process smooth and which ones create friction. If you're evaluating TPAs or considering a change, that's something we can help with.
Let Us Help You Tell the Story
Every group has a story. Maybe they've had eight good years and one bad year. Maybe they have a high-cost claimant who's actually stable and well-managed. Maybe they've implemented cost containment programs that reduce their risk profile.
Carriers don't automatically know any of that. They see the data you send and they price accordingly.
Our job is to help you tell that story in a way that's accurate, complete, and positions the group as favorably as possible. But we can only do that if we have the full picture.
This isn't about sending more paperwork for the sake of it. It's about giving us the context to advocate on your behalf—to push back on conservative assumptions, to highlight the programs that reduce risk, to find the carriers whose appetite matches the group's profile.
When brokers trust us with complete information, we can do what we're actually good at: finding creative solutions that protect employers and make brokers look like heroes to their clients.
The Bottom Line
I've always preferred working behind the scenes. I'm not the salesperson or the marketer—I'm the person making sure the details are right and the process runs smoothly.
From that vantage point, I can tell you: the cases that go well are the ones where we have everything we need from the start. The cases that struggle are usually missing something that would have changed the outcome.
Give us the data. Let us help you tell the story. That's how we get the best results for everyone.
*For stop-loss placement support or TPA evaluation guidance, contact XL Benefits.*