Short answer: A laser is a stop-loss term that gives one known high-cost person a higher specific deductible (or an exclusion) under the employer’s policy. It changes how much of that person’s claims the employer funds, not the employee’s benefits, and the plan still may not cut that person’s eligibility or charge them more because of their health.
Example from a hypothetical contract: a member has $250,000 of eligible claims and the specific deductible is $75,000, so the insurer reimburses $175,000 and the employer retains $75,000. If the carrier lasers that member at $200,000, the insurer reimburses only $50,000 and the employer retains $200,000, an extra $125,000.
The health plan’s obligations do not change. HIPAA nondiscrimination rules bar a group health plan from setting eligibility rules, or charging an individual a higher premium or contribution, based on a health factor. Removing or penalizing the employee to solve a stop-loss problem is not an option.
When comparing quotes, ask whether lasered amounts count toward the aggregate attachment point and whether the carrier promises no new lasers at renewal.