For reference, below are the proposals for gross and risk margin
Data based in Active, Completed and Abrogated OP through June 2025
Below is the summary of total price showing that the new margin scheme is revenue neutral over the 2020-2025 period
Diagnosis Type | Contract Price | New Contract Price | Count |
---|---|---|---|
ABI | 976,998,862 | 986,521,317 | 664 |
Amputation | 222,391,204 | 216,932,488 | 207 |
Burn Injury | 343,324,558 | 340,992,626 | 178 |
Multiple Trauma | 658,996,281 | 637,739,141 | 606 |
Other | 10,515,637 | 9,487,366 | 8 |
SCI | 675,066,557 | 698,424,615 | 315 |
Total | 2,887,293,099 | 2,890,097,552 | 1,978 |
The charts below show the statistics on price changes for our largest clients had the changes been in effect for years 2020 to 2024. The 10th to 90th percentile are less than +-10% for all clients. The upper range increases to about +17% for the 95th percentile, while a few cases (mainly SCI), exceed that threshhold due to a higher allowed limit on risk margin, which calculates a margin of between 20 and 30% for some SCI cases. There were 47 such cases for the 10 largest carriers and 99 overall for the 5 year period.
Primary Payer | Count | Mean | 5th Percentile | 10th Percentile | 90th Percentile | 95th Percentile |
---|---|---|---|---|---|---|
AIG Technical Third Party Oversight | 81 | -1.71% | -8.48% | -7.38% | 3.56% | 6.95% |
AXA XL | 52 | 0.39% | -8.89% | -7.52% | 10.38% | 17.25% |
Amerisure Mutual Insurance Company | 55 | -2.30% | -8.21% | -8.12% | 2.49% | 8.61% |
CNA | 44 | 1.50% | -7.79% | -6.84% | 13.62% | 14.63% |
Chubb | 274 | 0.43% | -10.31% | -7.98% | 9.87% | 13.14% |
Old Republic Risk Management | 42 | -1.03% | -10.12% | -7.99% | 6.89% | 9.05% |
Sentry Insurance | 50 | -0.23% | -8.37% | -6.91% | 10.23% | 10.78% |
Starr Indemnity and Liability Company | 40 | -2.72% | -10.44% | -8.95% | 2.84% | 6.70% |
Travelers | 153 | 0.63% | -8.91% | -7.15% | 9.73% | 13.56% |
Zurich North America | 402 | 0.89% | -7.53% | -4.80% | 8.56% | 12.03% |
The following charts show the dispersion of price changes about the mean
This table shows the ranges by diagnosis, which indicates the largest potential impact in SCI and ABI cases.
Primary Payer | Diagnosis Type | Count | Mean | 5th Percentile | 10th Percentile | 90th Percentile | 95th Percentile |
---|---|---|---|---|---|---|---|
AIG Technical Third Party Oversight | ABI | 33 | 0.52% | -5.71% | -4.58% | 3.48% | 7.11% |
AIG Technical Third Party Oversight | Amputation | 5 | -2.08% | -5.18% | -4.62% | 0.06% | 0.41% |
AIG Technical Third Party Oversight | Burn Injury | 10 | -2.25% | -9.16% | -7.90% | 3.00% | 3.66% |
AIG Technical Third Party Oversight | Multiple Trauma | 21 | -4.31% | -8.12% | -7.38% | -1.50% | 0.00% |
AIG Technical Third Party Oversight | Other | 1 | 3.32% | 3.32% | 3.32% | 3.32% | 3.32% |
AIG Technical Third Party Oversight | SCI | 11 | -2.11% | -12.22% | -11.31% | 5.48% | 7.07% |
AXA XL | ABI | 19 | -0.51% | -9.96% | -8.05% | 8.51% | 11.53% |
AXA XL | Amputation | 4 | -1.79% | -4.86% | -4.78% | 1.24% | 1.34% |
AXA XL | Burn Injury | 4 | -3.01% | -7.58% | -6.91% | 1.16% | 2.04% |
AXA XL | Multiple Trauma | 18 | -1.24% | -6.23% | -5.89% | 4.56% | 6.78% |
AXA XL | SCI | 7 | 4.48% | -11.17% | -9.25% | 17.36% | 17.81% |
Amerisure Mutual Insurance Company | ABI | 19 | -0.93% | -8.53% | -6.71% | 8.46% | 9.89% |
Amerisure Mutual Insurance Company | Amputation | 8 | -3.12% | -5.41% | -5.15% | -1.05% | -0.52% |
Amerisure Mutual Insurance Company | Burn Injury | 3 | 1.70% | -5.09% | -4.86% | 10.14% | 11.78% |
Amerisure Mutual Insurance Company | Multiple Trauma | 24 | -4.58% | -8.37% | -8.12% | -1.45% | -0.56% |
Amerisure Mutual Insurance Company | SCI | 1 | -4.43% | -4.43% | -4.43% | -4.43% | -4.43% |
CNA | ABI | 14 | 2.47% | -5.72% | -5.09% | 13.53% | 16.59% |
CNA | Amputation | 5 | 0.35% | -1.20% | -0.90% | 1.94% | 2.58% |
CNA | Burn Injury | 8 | 1.75% | -6.41% | -4.97% | 14.35% | 15.12% |
CNA | Multiple Trauma | 8 | -3.34% | -7.86% | -7.60% | 2.59% | 4.00% |
CNA | Other | 1 | -10.85% | -10.85% | -10.85% | -10.85% | -10.85% |
CNA | SCI | 8 | 4.42% | -5.84% | -5.51% | 13.73% | 14.07% |
Chubb | ABI | 89 | 1.60% | -6.96% | -5.03% | 9.92% | 11.30% |
Chubb | Amputation | 40 | -2.94% | -7.09% | -5.92% | 0.67% | 2.87% |
Chubb | Burn Injury | 24 | 0.43% | -6.39% | -5.03% | 12.10% | 14.54% |
Chubb | Multiple Trauma | 78 | -4.54% | -8.12% | -8.12% | -1.05% | 0.11% |
Chubb | Other | 1 | -10.49% | -10.49% | -10.49% | -10.49% | -10.49% |
Chubb | SCI | 42 | 1.30% | -17.65% | -13.87% | 18.09% | 22.74% |
Old Republic Risk Management | ABI | 15 | -2.29% | -10.22% | -9.30% | 4.00% | 5.34% |
Old Republic Risk Management | Amputation | 2 | -2.61% | -3.61% | -3.50% | -1.72% | -1.61% |
Old Republic Risk Management | Burn Injury | 5 | -3.52% | -8.49% | -7.80% | 0.15% | 0.20% |
Old Republic Risk Management | Multiple Trauma | 12 | -4.57% | -7.99% | -7.94% | -2.22% | 2.59% |
Old Republic Risk Management | SCI | 8 | 0.86% | -10.39% | -8.02% | 12.32% | 13.14% |
Sentry Insurance | ABI | 11 | -0.64% | -7.72% | -6.86% | 10.36% | 11.61% |
Sentry Insurance | Amputation | 7 | -3.20% | -6.34% | -6.15% | -0.65% | -0.32% |
Sentry Insurance | Burn Injury | 2 | 3.82% | -1.93% | -1.29% | 8.94% | 9.58% |
Sentry Insurance | Multiple Trauma | 19 | -3.98% | -7.45% | -6.87% | -0.42% | 3.45% |
Sentry Insurance | SCI | 11 | 1.07% | -14.33% | -13.69% | 11.01% | 14.24% |
Starr Indemnity and Liability Company | ABI | 11 | -2.19% | -7.86% | -6.90% | 3.11% | 4.82% |
Starr Indemnity and Liability Company | Amputation | 4 | -2.57% | -3.66% | -3.66% | -0.89% | -0.44% |
Starr Indemnity and Liability Company | Burn Injury | 8 | -2.54% | -8.50% | -6.84% | 1.33% | 2.05% |
Starr Indemnity and Liability Company | Multiple Trauma | 8 | -4.93% | -8.81% | -7.29% | -1.42% | 0.44% |
Starr Indemnity and Liability Company | Other | 1 | -13.75% | -13.75% | -13.75% | -13.75% | -13.75% |
Starr Indemnity and Liability Company | SCI | 8 | 0.65% | -10.46% | -8.37% | 12.65% | 15.91% |
Travelers | ABI | 81 | 1.38% | -7.07% | -5.02% | 9.80% | 12.77% |
Travelers | Amputation | 4 | -4.72% | -6.95% | -6.51% | -3.16% | -2.90% |
Travelers | Burn Injury | 14 | -0.72% | -7.78% | -7.27% | 3.88% | 7.37% |
Travelers | Multiple Trauma | 28 | -3.03% | -6.87% | -6.26% | -0.84% | 0.04% |
Travelers | SCI | 26 | 0.63% | -12.92% | -11.69% | 16.60% | 18.13% |
Zurich North America | ABI | 103 | 3.15% | -5.01% | -4.12% | 10.97% | 12.50% |
Zurich North America | Amputation | 62 | 1.93% | -5.73% | -4.42% | 5.99% | 8.43% |
Zurich North America | Burn Injury | 36 | 2.31% | -1.84% | -1.41% | 7.39% | 9.82% |
Zurich North America | Multiple Trauma | 152 | -1.21% | -4.57% | -3.97% | 1.54% | 2.92% |
Zurich North America | Other | 2 | -7.07% | -13.43% | -12.72% | -1.41% | -0.71% |
Zurich North America | SCI | 47 | 0.46% | -15.50% | -12.12% | 18.38% | 21.53% |
Now we show the average price changes for Zurich if we hold the gross margin constant and only change risk margin, and vice versa
Diagnosis Type | Count | Risk Change | Gross Change | Total Change |
---|---|---|---|---|
ABI | 103 | 1.01169 | 1.0205 | 1.03293 |
Amputation | 62 | 0.97675 | 1.0237 | 1.00022 |
Burn Injury | 36 | 0.98741 | 1.0312 | 1.01776 |
Multiple Trauma | 152 | 0.95914 | 1.0235 | 0.98079 |
Other | 2 | 0.86874 | 1.0333 | 0.89373 |
SCI | 47 | 0.98318 | 1.0400 | 1.02203 |
Diagnosis Type | Count | Risk Change | Gross Change | Total Change |
---|---|---|---|---|
ABI | 395 | 1.00566 | 1.0103 | 1.01607 |
Amputation | 141 | 0.97506 | 1.0088 | 0.98348 |
Burn Injury | 114 | 0.97323 | 1.0181 | 0.99082 |
Multiple Trauma | 368 | 0.96161 | 1.0113 | 0.97210 |
Other | 6 | 0.87411 | 1.0356 | 0.89840 |
SCI | 169 | 0.99564 | 1.0346 | 1.02935 |
Below is the price change per year for Zurich
Effective Year | Count | Risk Change | Gross Change | Total Change |
---|---|---|---|---|
2020 | 51 | 0.96826 | 1.0288 | 0.99540 |
2021 | 66 | 1.00239 | 1.0289 | 1.03125 |
2022 | 63 | 1.00128 | 1.0322 | 1.03443 |
2023 | 75 | 0.97087 | 1.0183 | 0.98802 |
2024 | 106 | 0.97864 | 1.0244 | 1.00185 |
2025 | 41 | 0.96693 | 1.0305 | 0.99539 |
And for the Top 10
Diagnosis Type | Count | Risk Change | Gross Change | Total Change |
---|---|---|---|---|
2020 | 186 | 0.98050 | 1.0155 | 0.99500 |
2021 | 201 | 0.99469 | 1.0228 | 1.01740 |
2022 | 186 | 1.00596 | 1.0188 | 1.02582 |
2023 | 244 | 0.97253 | 1.0128 | 0.98444 |
2024 | 270 | 0.97909 | 1.0155 | 0.99370 |
2025 | 106 | 0.98610 | 1.0119 | 0.99644 |
The increase of price for Zurich is due to the higher proportion of sub-500K contracts compared to the average. The second table shows an average increase for Zurich of almost 6% in gross margin for sub-500K contracts, with a new gross margin of 30%
Budget/Payer | Amerisure Mutual Insurance Company | Starr Indemnity and Liability Company | Old Republic Risk Management | Sentry Insurance | CNA | AXA XL | AIG Technical Third Party Oversight | Travelers | Chubb | Zurich North America | Total |
---|---|---|---|---|---|---|---|---|---|---|---|
A- 0-500K | 16 (19.8%) | 15 (27.3%) | 12 (23.1%) | 93 (33.9%) | 2 (4.5%) | 5 (11.9%) | 10 (20.0%) | 8 (20.0%) | 18 (11.8%) | 161 (40.0%) | 340 (28.5%) |
B- 500-750 | 14 (17.3%) | 17 (30.9%) | 9 (17.3%) | 44 (16.1%) | 7 (15.9%) | 10 (23.8%) | 14 (28.0%) | 10 (25.0%) | 27 (17.6%) | 70 (17.4%) | 222 (18.6%) |
C- 750-1M | 18 (22.2%) | 8 (14.5%) | 8 (15.4%) | 48 (17.5%) | 8 (18.2%) | 12 (28.6%) | 7 (14.0%) | 4 (10.0%) | 33 (21.6%) | 71 (17.7%) | 217 (18.2%) |
D- 1M-1.25M | 10 (12.3%) | 4 (7.3%) | 4 (7.7%) | 31 (11.3%) | 7 (15.9%) | 3 (7.1%) | 6 (12.0%) | 7 (17.5%) | 20 (13.1%) | 30 (7.5%) | 122 (10.2%) |
E- 1.25M-1.5M | 5 (6.2%) | 8 (14.5%) | 5 (9.6%) | 18 (6.6%) | 7 (15.9%) | 3 (7.1%) | 6 (12.0%) | 2 (5.0%) | 18 (11.8%) | 19 (4.7%) | 91 (7.6%) |
F- 1.5M-1.75M | 8 (9.9%) | 1 (1.8%) | 6 (11.5%) | 11 (4.0%) | 6 (13.6%) | 2 (4.8%) | 2 (4.0%) | 2 (5.0%) | 20 (13.1%) | 26 (6.5%) | 84 (7.0%) |
G- 1.75M-2M | 3 (3.7%) | 1 (1.8%) | 3 (5.8%) | 9 (3.3%) | 1 (2.3%) | 2 (4.8%) | 0 (0.0%) | 3 (7.5%) | 7 (4.6%) | 10 (2.5%) | 39 (3.3%) |
H- 2M-2.5M | 3 (3.7%) | 1 (1.8%) | 2 (3.8%) | 14 (5.1%) | 2 (4.5%) | 4 (9.5%) | 2 (4.0%) | 2 (5.0%) | 4 (2.6%) | 9 (2.2%) | 43 (3.6%) |
I- 2.5M-3M | 2 (2.5%) | 0 (0.0%) | 1 (1.9%) | 4 (1.5%) | 1 (2.3%) | 1 (2.4%) | 1 (2.0%) | 0 (0.0%) | 2 (1.3%) | 1 (0.2%) | 13 (1.1%) |
J- Over 3M | 2 (2.5%) | 0 (0.0%) | 2 (3.8%) | 2 (0.7%) | 3 (6.8%) | 0 (0.0%) | 2 (4.0%) | 2 (5.0%) | 4 (2.6%) | 5 (1.2%) | 22 (1.8%) |
Total | 81 (100.0%) | 55 (100.0%) | 52 (100.0%) | 274 (100.0%) | 44 (100.0%) | 42 (100.0%) | 50 (100.0%) | 40 (100.0%) | 153 (100.0%) | 402 (100.0%) | 1,193 (100.0%) |
The chart below indicates the possible need for a favored nations gross margin to remain in place.
Claim Budget | Count | Risk Change | Gross Change | Total Change | Current GM | New GM |
---|---|---|---|---|---|---|
A- 0-500K | 161 | 0.97362 | 1.0428 | 1.01421 | 26.2% | 29.0% |
B- 500-750 | 70 | 0.96486 | 1.0231 | 0.98623 | 26.5% | 28.0% |
C- 750-1M | 71 | 0.98164 | 1.0202 | 1.00120 | 25.7% | 27.0% |
D- 1M-1.25M | 30 | 0.97500 | 1.0057 | 0.98064 | 25.6% | 26.0% |
E- 1.25M-1.5M | 19 | 0.98478 | 1.0247 | 1.00912 | 23.5% | 25.0% |
F- 1.5M-1.75M | 26 | 1.01354 | 1.0268 | 1.04192 | 21.2% | 23.0% |
G- 1.75M-2M | 10 | 0.98809 | 1.0438 | 1.02956 | 19.2% | 22.0% |
H- 2M-2.5M | 9 | 0.97963 | 1.0261 | 1.00474 | 18.2% | 20.0% |
I- 2.5M-3M | 1 | 1.12195 | 1.0000 | 1.12195 | 18.0% | 18.0% |
J- Over 3M | 5 | 0.99010 | 1.0286 | 1.01990 | 14.7% | 17.0% |
Next we show the loss ratio based on the original contract price v the new contract price
Payer | Current Price | New Price |
---|---|---|
AIG Technical Third Party Oversight | 73.39% | 74.67% |
AXA XL | 80.27% | 79.96% |
Amerisure Mutual Insurance Company | 68.78% | 70.39% |
CNA | 70.53% | 69.49% |
Chubb | 73.71% | 73.39% |
Old Republic Risk Management | 77.30% | 78.11% |
Sentry Insurance | 64.40% | 64.55% |
Starr Indemnity and Liability Company | 65.31% | 67.14% |
Travelers | 74.02% | 73.55% |
Zurich North America | 70.55% | 69.93% |
Payer | Effective Year | Current Price | New Price |
---|---|---|---|
AIG Technical Third Party Oversight | 2020 | 66.69% | 66.26% |
AIG Technical Third Party Oversight | 2021 | 85.44% | 88.55% |
AIG Technical Third Party Oversight | 2022 | 75.36% | 75.62% |
AIG Technical Third Party Oversight | 2023 | 71.00% | 71.41% |
AIG Technical Third Party Oversight | 2024 | 71.27% | 74.06% |
AIG Technical Third Party Oversight | 2025 | 75.98% | 76.34% |
AXA XL | 2020 | 92.39% | 90.86% |
AXA XL | 2021 | 87.46% | 84.19% |
AXA XL | 2022 | 79.71% | 74.37% |
AXA XL | 2023 | 76.70% | 79.51% |
AXA XL | 2024 | 69.49% | 70.51% |
AXA XL | 2025 | 65.45% | 70.47% |
Amerisure Mutual Insurance Company | 2020 | 75.66% | 78.41% |
Amerisure Mutual Insurance Company | 2021 | 67.03% | 67.19% |
Amerisure Mutual Insurance Company | 2022 | 73.62% | 73.38% |
Amerisure Mutual Insurance Company | 2023 | 70.79% | 73.77% |
Amerisure Mutual Insurance Company | 2024 | 62.90% | 64.90% |
Amerisure Mutual Insurance Company | 2025 | 59.60% | 63.44% |
CNA | 2020 | 64.26% | 64.22% |
CNA | 2021 | 59.45% | 60.42% |
CNA | 2022 | 77.63% | 74.75% |
CNA | 2023 | 72.30% | 70.95% |
CNA | 2024 | 75.02% | 74.65% |
CNA | 2025 | 64.43% | 61.54% |
Chubb | 2020 | 65.52% | 65.98% |
Chubb | 2021 | 80.36% | 79.24% |
Chubb | 2022 | 81.22% | 78.59% |
Chubb | 2023 | 69.02% | 70.79% |
Chubb | 2024 | 77.03% | 76.93% |
Chubb | 2025 | 58.65% | 57.93% |
Old Republic Risk Management | 2020 | 89.58% | 88.73% |
Old Republic Risk Management | 2021 | 78.97% | 77.26% |
Old Republic Risk Management | 2022 | 63.58% | 63.73% |
Old Republic Risk Management | 2023 | 83.48% | 83.59% |
Old Republic Risk Management | 2024 | 79.97% | 82.70% |
Old Republic Risk Management | 2025 | 60.60% | 63.73% |
Sentry Insurance | 2020 | 59.15% | 63.58% |
Sentry Insurance | 2021 | 74.98% | 75.04% |
Sentry Insurance | 2022 | 58.87% | 58.40% |
Sentry Insurance | 2023 | 70.26% | 72.17% |
Sentry Insurance | 2024 | 72.29% | 71.21% |
Sentry Insurance | 2025 | 10.32% | 10.42% |
Starr Indemnity and Liability Company | 2020 | 64.64% | 66.68% |
Starr Indemnity and Liability Company | 2021 | 62.80% | 63.42% |
Starr Indemnity and Liability Company | 2022 | 68.12% | 67.87% |
Starr Indemnity and Liability Company | 2023 | 62.02% | 67.71% |
Starr Indemnity and Liability Company | 2024 | 69.09% | 70.58% |
Starr Indemnity and Liability Company | 2025 | 59.07% | 60.76% |
Travelers | 2020 | 74.21% | 74.20% |
Travelers | 2021 | 74.29% | 72.48% |
Travelers | 2022 | 74.10% | 72.77% |
Travelers | 2023 | 72.83% | 72.82% |
Travelers | 2024 | 75.12% | 75.76% |
Travelers | 2025 | 75.06% | 74.26% |
Zurich North America | 2020 | 66.86% | 67.17% |
Zurich North America | 2021 | 77.62% | 75.27% |
Zurich North America | 2022 | 68.95% | 66.66% |
Zurich North America | 2023 | 64.68% | 65.46% |
Zurich North America | 2024 | 74.29% | 74.15% |
Zurich North America | 2025 | 66.15% | 66.45% |
This methodology would have led to fewer bookends, both Windfalls and Losses.
Bookend | Current | New |
---|---|---|
L | 160 | 155 |
N | 1501 | 1514 |
W | 317 | 309 |
There is a slightly larger proportion of risk cap eligible contracts (loss ratio < 61%) in the general client population as opposed to the top ten payers. Note this includes Completed, Abrogated and Active at 6/30/2025.
Risk Cap Cutoff | Count | Contract Price | Percent Count | Percent Price |
---|---|---|---|---|
Over | 785 | 1,197,128,397 | 66.9% | 71.7% |
Under | 388 | 473,634,656 | 33.1% | 28.3% |
And at the proposed new price
Risk Cap Cutoff | Count | New Contract Price | Percent Count | Percent Price |
---|---|---|---|---|
Over | 803 | 1,220,170,996 | 68.5% | 72.9% |
Under | 370 | 453,641,870 | 31.5% | 27.1% |
Below is the risk cap exposure for all other payers out of the top ten
Risk Cap Cutoff | Count | Contract Price | Percent Count | Percent Price |
---|---|---|---|---|
Over | 475 | 788,134,952 | 61.3% | 67.0% |
Under | 300 | 388,273,096 | 38.7% | 33.0% |
And at the new proposed prices.
Risk Cap Cutoff | Count | New Contract Price | Percent Count | Percent Price |
---|---|---|---|---|
Over | 499 | 808,628,939 | 64.4% | 68.7% |
Under | 276 | 367,839,212 | 35.6% | 31.3% |