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U.S. employers may have been a little more likely to use self-insured health plans in 2024 and a lot more likely to use stop-loss insurance to protect whatever self-insured plans they offered.
Paul Fronstin, an analyst at the Employee Benefit Research Institute, reports in EBRI's latest self-insured market review that the percentage of employers with health plans that offered workers at least one self-insured coverage option increased to 40% last year, up from 38% in 2023.
The percentage of employers with self-insured plans that used stop-loss insurance to protect the plans against catastrophic losses may have jumped to 74%, from 65% the year before.
In 2024, EBRI reported that the percentage of employers with self-insured health plans had held steady, at 38%, between 2022 and 2023, and that the percentage using stop-loss insurance had increased just a little — to 65%, from 63%.
EBRI bases its self-insured plan reports on data collected by the U.S. Census Bureau's Medical Expenditure Panel Survey-Insurance Component.
Fronstin emphasized that he wants to see stop-loss data for 2025 before accepting the MEPS-IC stop-loss numbers at face value.
"This large one-year change could be a statistical anomaly," he warned.
EBRI shows use of stop-loss by self-insured plans at employers with 100 to 999 employees holding steady at 93%.
But it found that reported use of stop-loss at bigger employers increased to 71%, from 60%.
Reported stop-loss use climbed to 70%, from 63%, at employers with 25 to 99 employees; to 29%, from 21%, at self-insured employers with fewer than 10 employees; and to 52%, from 34%, at employers with 10 to 24 employees.
The backdrop: The EBRI report showing significant stop-loss market expansion comes as executives at big stop-loss providers are talking about concerns about rising claims.
Related: Stop-loss premium hikes cool slightly
In recent months, executives at Aetna, Cigna, Elevance, UnitedHealth, Sun Life and Voya have all talked about employer plan costs increasing faster than they had originally hoped but within the high levels now expected.
Executives at some insurers have emphasized their lack of interest in increasing stop-loss sales at this time.
Sun Life executives have suggested that they believe they have stormproofed their stop-loss prices and underwriting rules well enough that they can compete hard for stop-loss renewals and new stop-loss sales.
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