Credit: Rob hyrons/Adobe Stock
The prices that self-insured employers are paying for medical stop-loss this year may be increasing a little more slowly this year than in 2024.
Analysts at the Segal Group, a New York-based benefits and compensation consulting firm, found that stop-loss prices for employers that held benefits the same are 9.7% higher this year than they were last year.
The rate of increase for employers that held benefits the same is down from 11.5% in 2024.
Related: Medical stop-loss premiums rise 11.5% for self-funded plans
For employers that increased deductibles and took other steps to cut stop-loss premiums, the rate of increase cooled to 7.3%, from 9.4% last year.
Stop-loss basics: Stop-loss insurance is a kind of insurance for insurance plans.
Employers with self-insured plans can use stop-loss to protect the plans against the risk that individual patients will need very expensive care, such as organ transplants.
Employers can also use stop-loss to protect self-insured plans against the risk of factors, such as influenza or COVID-19 epidemics, that could increase overall plan costs.
The data: Segal based the new analysis on data from 221 plans with an average of about 2,300 covered participants.
Analysis details: For a plan with a $500,000 "specific stop-loss deductible," or deductible for very expensive care for individual patients, median premiums increased 22%, to $48.65.
The percentage of employers with specific stop-loss deductibles under $400,000 fell to 47%, from 51%.
The percentage with deductibles of $700,000 or higher increased to 19%, from 16%.
The future: The increase in stop-loss insurance rates could cause some employers to try to go bare, or to use fully insured coverage.
But Tim Noel, an executive at UnitedHealth, predicted Tuesday that increases in the cost of fully insured group health insurance could increase the number that self-insure. That could help stabilize use of stop-loss insurance in 2026.
© Arc, All Rights Reserved. Request academic re-use from www.copyright.com. All other uses, submit a request to TMSalesOperations@arc-network.com. For more information visit Asset & Logo Licensing.