Understanding Gene Therapy Stop Loss
Gene therapies offer the promise of potential cures for disease and genetic disorders, yet come at unprecedented costs ($2M to $4M per treatment). Self-funded employers are exposed to both frequency and severity of these catastrophic $2-4M claims. That’s why BCS has developed gene therapy stop loss products, known as Stop Loss GT and Stop Loss GTS, to fit the need of large and small-to-mid-sized employers.
Rates are now available for 1/1/2026. Contact us to get started.
Gene Therapy Stop Loss Frequently Asked Questions (FAQs)
Stop loss is a coverage acquired by employers to provide a cap in high-cost claims for self-insured employers. With the growth of gene therapy, often priced at $2-4M per treatment, many employers are seeking additional protection from these catastrophic claims.
Gene therapy is a technique that uses a gene(s) to treat, prevent, or cure a disease or medical disorder. Often, gene therapy works by adding new copies of a gene that is broken, or by replacing a defective or missing gene in a patient’s cells with a healthy version of that gene.
Stop Loss GT and GTS are two gene therapy stop loss products provided by BCS. Unlike traditional stop loss, the key difference is these products provide stop loss coverage for gene therapy costs only.
Stop Loss GT is a standalone product. This product can be a great fit for jumbo employers who do not buy stop loss coverage but want some protection from frequency of expensive gene therapy treatments.
Stop Loss GTS is designed to sit alongside a traditional stop loss policy, and provide protection for the growing risk of gene therapies by carving out the gene therapy ingredient cost risk from the traditional stop loss policy. This product can be a great fit for smaller to mid-size employers who seek additional protection.
Stop Loss GT is designed to cover jumbo employer groups. We will generally consider employers above 3,000 employee lives.
Stop Loss GTS is designed to cover small-to-mid-sized groups of 101 or more employees. Employers are expected to have their own traditional stop loss policy in force – this is designed to cover the gene therapy ingredient cost only.
Both products provide coverage for named therapies. Depending on the option selected, coverage can include specific therapies expected to hit the market in 2026/2027. These will be covered upon FDA approval.
BCS Stop Loss GT and GTS are fully underwritten products.
Next Steps
Contact BCS to begin the quoting process today!
