Medical Stop Loss Premium Survey

About the Survey


The 2019 Aegis Risk Medical Stop Loss Premium Survey, in its thirteenth year, represents 539 plan sponsors covering over 940,000 employees with over $464 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 2019 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, pharmacy coverage and projected 2020 remium levels.


Contact us to receive a FREE copy of the 2019 Survey results (available mid-September) and be notified on the opening of the 2020 Survey next Spring. Provide name, email and organization. Respondents receive an initial, earlier receipt of the Survey results each August.


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


Key Survey Findings - 2019


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 $142.69 per employee per month (PEPM) for a $100,000 Individual deductible to $25.50 PEPM for a $500,000 Individual deductible (see below table).

Further Market Observations


Our ongoing observations on the stop loss market include:


  • Occurrence of catastrophic claimants. When surveyed, 64% of respondents report at least one claimant in excess of $500,000 paid in the last two policy years. Most notably, three out of ten report a claimant in excess of $1 million, with about half of those in excess of $1.5 million.


  • Interest in alternative risk management strategies is slight. With increased focus on health care costs and self-funding, various risk management strategies are being discussed. However, actual interest in each approach lacks, including captive arrangements at 14%. However, 8% report consideration of returning to fully-insured - up from the prior year at 1%. It may indicate that self-funding, while cost-efficient, may still  challenge some plan sponsors - possibly those smaller and recently transitioned. 


  • 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. It's a risk. Not an employee benefit. Be advised.


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.

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