Revenue from all stop-loss arrangements in force fell 14% between the first quarter of 2024 and the latest quarter, to $390 million.

The first quarter ended March 31.

Heather Lavallee, Voya's chief executive officer, implied today during a conference call with securities analysts that stop-loss prices could continue to rise if loss ratios stay high.

"Our teams are maintaining the same level of focus and discipline in 2025, heading into 2026," that they carried into the start of this year, Lavallee said.

Stop-loss insurance basics: Employers with self-insured health plans use stop-loss to protect themselves from catastrophic losses.

Few health insurers say much about their fully insured group health products these days. Comments from insurers about stop-loss programs some clues about what's really happening inside employer plans.

Stop-loss claims start to flow in once employers hit their "attachment points," or stop-loss deductibles.

Voya's stop-loss loss ratios: Voya originally hoped its stop-loss arrangements would have a loss ratio of just 84% in 2024. Heavy use of care pushed the overall stop-loss loss ratio up to 115% in the fourth quarter.

This year, Voya is predicting that the stop-loss arrangements with policy years starting Jan. 1, 2025, will have an ultimate loss ratio of 87%, once all of the claims come in.

Lavallee told the analysts that the loss ratio figures for 2024 are starting to firm up now and that the company won't have much data for 2025 until the third quarter.

Voya is trying to get an early view by using tracking reports that show how many employer plan claims are approaching 50% of the deductible, Lavallee said.

Voya now owns a benefits advisor support services provider, Benefitfocus, and it sees the advisors associated with Benefitfocus as another source of clues about claims.

"We are certainly continuing to stay close to our advisors to see how trends are emerging," Lavallee said.

What it means: Clients who have been trying to save money by combining self-insured coverage with stop-loss insurance may have to review their strategy.

If the cost of fully insured coverage rises more slowly than stop-loss prices, fully insured coverage could turn out to be a better deal for some employers.

If the same forces push up costs for fully insured coverage and stop-loss coverage at about the same rate, some employers may simply choose to pay more for coverage.

Other employers could drop health benefits or move to new types of arrangements, such as programs that provide a set amount of cash that employees can use to buy their own coverage or plans that encourage enrollees to use a small number of doctors available through a direct primary care arrangement.