New benefit designed to help customers address high cost of cell and gene therapies

December 15, 2023 – Hamilton Square, New Jersey – Berkley Accident and Health, a Berkley Company, has added a new benefit to its Employer Stop Loss protection in response to the rapidly growing cell and gene therapy market. As more cell and gene therapies enter the market, employers may be faced with the challenge of paying for these high-dollar treatments. Berkley Accident and Health is proud to provide its self‑funded customers with a tangible benefit that can reduce the financial impact of these therapies.

“Cell and gene therapies are groundbreaking treatments that have the potential to reduce or cure life-threatening diseases. They can make a real difference to patients and their families,” said Brad Nieland, President and CEO. “However, they can also come with extraordinarily high costs. The latest gene therapies to enter the market have estimated costs of $2 million to $4 million,” explained Nieland. “That’s why we’re excited to proactively help customers navigate the complexities of cell and gene therapies and lower the financial burden. It’s part of our ongoing commitment to making self-funding more accessible and predictable.”

Berkley Accident and Health’s new Cell and Gene Therapy Step-Down Deductible benefit is designed to help customers mitigate the risk of these transformative treatments. It lowers the Specific Stop Loss deductible for cell and gene therapy claims when an approved Center of Excellence network is utilized. Berkley Accident and Health has recently approved the Emerging Therapy Solutions (ETS) Center of Excellence, which provides customer assistance with education, network and contract evaluation, and access to preferred pricing at leading facilities nationwide. 

Benefit Highlights

The Cell and Gene Therapy Step-Down Deductible endorsement is:

• Available at no additional cost to all Stop Loss policyholders and members of Group Captive programs
• Automatically added to all new and renewal Stop Loss policies with 1/1/24 effective dates or later[1]

A top ten independent Stop Loss provider,[2] Berkley Accident and Health is committed to finding new ways to make self-funding less volatile and put it within reach of more companies.

The Cell and Gene Therapy Step-Down Deductible reduces the policyholder’s Stop Loss deductible for qualifying claims, provided certain provisions are included in the employer’s plan. For more details, please contact your Berkley Accident and Health representative.

About Berkley Accident and Health

Berkley Accident and Health is committed to protecting the financial well-being of people and organizations. We are an industry leader offering an innovative portfolio of accident and health solutions and the personal support that our clients need. Berkley Accident and Health is a member of W. R. Berkley Corporation, a Fortune 500 company, and provides Employer Stop Loss, Group Captive, Specialty Accident, and Managed Care solutions nationwide. Stop Loss and Managed Care coverage is underwritten by Berkley Life and Health Insurance Company, rated A+ (Superior) by A.M. Best. Specialty Accident coverage is underwritten by Berkley Life and Health Insurance Company or StarNet Insurance Company. For more information, please visit www.BerkleyAH.com.

[1] Subject to state approval

[2] MyHealthGuide.com, Medical Stop-Loss Provider Ranking, June 12, 2023, https://www.myhealthguide.com. An independent stop loss provider is one that does not sell claims administration services. 

Berkley Accident and Health assumes no responsibility or liability for any advice or resources provided by ETS. ETS makes no representation, warranty, or commitment of any kind regarding the outcome of any care provided or the coverage or payment for the same.Stop Loss is underwritten by Berkley Life and Health Insurance Company, a member company of W. R. Berkley Corporation and rated A+ (Superior) by A.M. Best, and involves the formation of a group captive insurance program that involves other employers and requires other legal entities. Berkley and its affiliates do not provide tax, legal, or regulatory advice concerning EmCap. You should seek appropriate tax, legal, regulatory, or other counsel regarding the EmCap program, including, but not limited to, counsel in the areas of ERISA, multiple employer welfare arrangements (MEWAs), taxation, and captives. EmCap is not available to all employers or in all states. Payment of claims under any insurance policy issued shall only be made in full compliance with all United States economic or trade and sanction laws or regulation, including, but not limited to, sanctions, laws and regulations administered and enforced by the U.S. Treasury Department’s Office of Foreign Assets Control (“OFAC”).

BAH AD 2023-212