Medical Stop Loss Premium Survey

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About the Survey

 

The 2022 Aegis Risk Medical Stop Loss Premium Survey, in its sixteenth year, represents 938 plan policies covering almost 1,100,000 employees with over $775 million in annual stop loss premium. It is the only market-wide and plan sponsor-based survey focused exclusively on medical stop loss coverage.

The 2022 Survey includes a worksheet to compare your exact coverage and premium costs against Survey results. It also provides insight on aggregate coverage, catastrophic claimants, deductible by employer size, policy provisions and projected 2023 renewal premiums.

 

Contact us to receive a FREE copy of the 2022 Survey results (available early-September) and be notified on the opening of the 2023 Survey that Spring. Provide name, email and organization. Respondents obtain early pre-release receipt of the Survey results in August.

 

Plan sponsors, as well as brokers and consultants, are encouraged to participate.

 

Key Survey Findings - 2022

 

Stop loss premiums vary widely due to deductible size. However, when normalized by contract (e.g. Paid, 12/12), an average cost is determined across the range of deductibles. 

 

According to the Survey, average premium (normalized to a Paid contract) ranges from $173.00 per employee per month (PEPM) for a $100,000 Individual deductible to $36.18 PEPM for a $500,000 Individual deductible (see below table).

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Further Market Observations

 

Our ongoing observations on the stop loss market include:

 

  • Occurrence of catastrophic claimants. When surveyed, 24% of respondents report a claimant in excess of $1,000,000 paid in the last two policy years, with 11% of those in excess of $1,500,000.

 

  • With increased focus on health care costs and self-funding, various risk management strategies are being discussed. But 62% respond as "none of the above", including reference-based pricing and direct provider contracting, both getting less than 5% interest. However, interest in a specialty Rx/gene therapy carve out attracted 16%.

 

  • Be knowledgeable. Identify the best carriers and use an experienced broker or consultant. Stop loss is highly specialized reinsurance, with very high claim exposure. An inexperienced advisor can cost your plan hundreds of thousands with a single claimant gap.

 

Aegis Risk helps its clients and partners gain competitive positioning against these dynamics through comprehensive, data-focused and knowledgeable approaches to the medical stop loss market. As we like to say: It's a risk. Not an employee benefit. Be advised.