Cancer diagnosis? Sun Life's Expert Cancer Review provides a lifeline to second opinions

Rhea-AI Summary

Sun Life U.S. (SLF) has launched Expert Cancer Review, a new service embedded in their stop-loss insurance plans starting July 1, 2025. The service provides cancer patients access to independent oncology specialist second opinions. This initiative addresses a critical healthcare need, as cancer represents the highest-cost claims, accounting for over 40% of total claims spend, particularly among adults aged 40-59. Data from 2023-2024 shows that 39% of members seeking second opinions experienced changes in their diagnostic strategy, diagnosis, or treatment plan. The service leverages Health Navigator's expertise, offering dedicated care advisors who coordinate with independent oncologists to provide comprehensive reviews in plain language to both members and treating physicians. This service will be available to self-funded employee health plans, which cover 63% of U.S. workers according to KFF.

Positive

• Service is automatically embedded in new and renewing stop-loss plans at no additional cost
• Addresses the highest-cost claims category (cancer) which accounts for 40% of total claims spend
• 39% of second opinions led to changes in diagnostic strategy or treatment plans
• Leverages existing Health Navigator infrastructure for seamless implementation

Negative

• None.

Insights

Healthcare Insurance Industry Analyst

Sun Life embeds expert cancer second opinion service into stop-loss plans, potentially improving outcomes while addressing their largest claims category.

Sun Life's new Expert Cancer Review service represents a strategic enhancement to their stop-loss insurance portfolio. By providing access to second opinions from independent oncology specialists, Sun Life is directly addressing what their data identifies as their most significant claims expense - cancer diagnoses account for more than 40% of their total claims spend.

The business case is compelling: Sun Life's internal data shows that 39% of members who sought second opinions experienced changes in their diagnostic strategy, diagnosis, or treatment plan. By embedding this service in all new and renewing stop-loss plans beginning July 1, Sun Life creates potential value on multiple fronts:

• For self-funded employers: Enhanced benefits without additional explicit costs
• For members: Improved diagnostic confidence and potentially more appropriate treatment
• For Sun Life: Possible reduction in unnecessary or ineffective treatments that drive high-cost claims

This move aligns with the industry trend toward insurers evolving from pure financial risk-bearers to healthcare solution providers. By leveraging their existing Health Navigator platform, Sun Life can deliver this specialized service efficiently while positioning themselves as a more comprehensive partner to the 63% of U.S. workers covered by self-funded health plans.

The integration of clinical expertise with their core insurance offering demonstrates Sun Life's understanding that better healthcare navigation can create value for all stakeholders in the self-funded ecosystem. This enhancement strengthens their market position in the competitive stop-loss insurance landscape while addressing a critical healthcare need.

New service embedded in Sun Life stop-loss coverage boosts employees' understanding of cancer diagnoses and confidence in treatment plans

WELLESLEY, Mass., June 18, 2025 /PRNewswire/ -- Sun Life U.S., the leading independent provider of medical stop-loss insurance in the country, today announced the launch of its Expert Cancer Review service, which provides members facing a cancer diagnosis with access to an objective, documented second opinion from an independent oncology specialist. The new service will be embedded in new and renewing Sun Life stop-loss plans beginning July 1.

The introduction of Expert Cancer Review comes at a crucial time in healthcare. Sun Life's annual high-cost claims report shows that cancer consistently ranks as the most common and costly condition across the country. Malignant neoplasm diagnoses, particularly in adults ages 40-59, account for more than 40% of total claims spend. Ensuring the best treatment plan is in place can provide peace of mind and prevent delays in treatment or unnecessary medical costs for the member undergoing care.  

"As a former nurse, I recognize the profound impact a cancer diagnosis can have on people. By offering access to expert second opinions, we will be able to empower our members with knowledge and give them confidence in their cancer treatment plans," said Jennifer Collier, president, Health and Risk Solutions, Sun Life U.S. "This new service reflects our commitment to helping members get the care they need, ensuring they are supported and well informed during a challenging time."

Second opinions, whether for cancer or other diagnoses, can have significant impact on the patient's health journey. Sun Life data from 2023-2024 showed that 39% of members who sought second opinions from qualified specialists saw a change in their diagnostic strategy, diagnosis or treatment plan.

Collier continued, "Second opinions can be a game changer, potentially avoiding misdiagnoses, sparing people from unnecessary treatments, uncovering better-tailored therapies and even reducing medical costs."

Expert Cancer Review harnesses the clinical expertise of Health Navigator, Sun Life's healthcare navigation and advocacy service. Health Navigator provides support for all health conditions with one-on-one care advisors who help members get the right diagnoses, doctors and treatments. For members using Expert Cancer Review, this dedicated team coordinates with independent expert oncologists to ensure thorough reviews and answer questions. The resulting opinions, written in plain language, are sent to the member and treating physician. 

As a stop-loss provider, Sun Life covers high-dollar claims for employers who self-fund their employee health plans. According to KFF, an independent non-profit organization focused on national health issues, 63% of covered workers in the U.S. are in a plan that is self-funded.

About Sun Life

Sun Life is a leading international financial services organization providing asset management, wealth, insurance and health solutions to individual and institutional Clients. Sun Life has operations in a number of markets worldwide, including Canada, the United States, the United Kingdom, Ireland, Hong Kong, the Philippines, Japan, Indonesia, India, China, Australia, Singapore, Vietnam, Malaysia and Bermuda. As of March 31, 2025, Sun Life had total assets under management of C$1.55 trillion. For more information, please visit www.sunlife.com.

Sun Life Financial Inc. trades on the Toronto (TSX), New York (NYSE) and Philippine (PSE) stock exchanges under the ticker symbol SLF.

Sun Life U.S. is one of the largest providers of employee and government benefits, helping approximately 50 million Americans access the care and coverage they need. Through employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation. Sun Life employs more than 8,300 people in the U.S., including associates in our partner dental practices and affiliated companies in asset management. Group insurance policies are issued by Sun Life Assurance Company of Canada (Wellesley Hills, Mass.), except in New York, where policies are issued by Sun Life and Health Insurance Company (U.S.) (Lansing, Mich.). For more information visit our website and newsroom.

Anjie Coplin
Sun Life U.S.
Anjie.Coplin@sunlife.com

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SOURCE Sun Life U.S.

FAQ

What is Sun Life's Expert Cancer Review service and when does it launch?

Expert Cancer Review is a service providing cancer patients access to independent oncology specialist second opinions, launching July 1, 2025 for Sun Life stop-loss insurance plans.

How effective are second opinions according to Sun Life's (SLF) data?

According to Sun Life's 2023-2024 data, 39% of members who sought second opinions experienced changes in their diagnostic strategy, diagnosis, or treatment plan.

What percentage of claims spend does cancer represent in Sun Life's stop-loss coverage?

Cancer (malignant neoplasm) diagnoses account for more than 40% of total claims spend, particularly in adults ages 40-59.

How does Sun Life's Expert Cancer Review service work?

The service uses Health Navigator's care advisors who coordinate with independent oncologists to review cases and provide written opinions in plain language to both the member and treating physician.

Who is eligible for Sun Life's Expert Cancer Review service?

The service is available to members covered under Sun Life stop-loss plans, which typically include employees in self-funded health plans (representing 63% of covered U.S. workers).