It’s a Risk. Not a Benefit. Be Advised.
Medical Stop Loss Premium Survey
About the Survey
The 2025 Aegis Risk Medical Stop Loss Premium Survey, in its nineteenth year, represents 1,268 plan policies covering over 1,200,000 employees with over $1.2 billion in annual stop loss premium. It is the only market-wide and plan sponsor-based survey focused exclusively on final, negotiated medical stop loss coverage.
The 2025 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 2026 renewal premiums.
Contact us to receive a FREE copy of the 2025 Survey results (available mid-September) and be notified on the opening of the 2026 Survey that Spring. Complete form as appropriate. Respondents obtain early, pre-release receipt of the Survey results each August.
Plan sponsors, as well as brokers and consultants, are encouraged to participate.
Key Survey Findings - 2025
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 $229.40 per employee per month (PEPM) for a $100,000 Individual deductible to $50.98 PEPM for a $500,000 Individual deductible (see below table).
Annual increase in stop loss premium, as measured from 2024 to 2025, confirm increases from 8.8% to nearly 10.5% or higher as the stop loss deductible increases - verifying leveraged trend impacts. However, longer term premium growth is more elevated, from 9.9% to 12.1% and may better reflect 2026 impacts.
Further Market Observations
Our ongoing observations on the stop loss market include:
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Occurrence of catastrophic claimants. When surveyed, 49% of respondents report a claimant in excess of $1,000,000 paid in the last two policy years, with 25% of those in excess of $1,500,000.
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With increased focus on health care costs and self-funding, various risk management strategies are being discussed. But 53% respond as "none of the above", including reference-based pricing and direct provider contracting, both getting no more than 4% interest. However, interest in a specialty Rx/gene therapy carve out attracted 21%.
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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 a benefit. Be advised.
