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A big nonprofit health insurer is suffering from the same kinds of problems in the U.S. stop-loss insurance market that for-profit competitors have talked about.
Highmark said Tuesday that HM Insurance Group, its stop-loss business, posted an operating loss of $107 million in 2025 on $1.3 billion in revenue.
That compares with an operating profit of $56 million on $1.2 billion in revenue for 2024.
Self-insured employers use stop-loss insurance to protect their health plans against catastrophic losses.
The loss at the Highmark stop-loss business was "driven by an increase in the frequency and severity of high-dollar claims," the company said in its annual report.
What it means: Stop-loss insurance providers may not be quick to offer employers good deals on coverage this year.
Highmark: Highmark is a Pittsburgh-based Blue Cross and Blue Shield carrier that is a major provider of coverage in Pennsylvania, Delaware, West Virginia and western New York state.
It's now in the process of acquiring Blue Cross and Blue Shield of Kansas City.
Highmark now provides or administers coverage for 7 million people, and completing the Kansas City Blue deal would add 1 million more enrollees.
The HM Insurance stop-loss business is one of the 10 biggest stop-loss providers. It has arranged to have the Canada Life Assurance Company, a unit of Great-West, reinsure 80% of its stop-loss business.
Highmark's results: Highmark, the parent company, recorded an operating loss of $674 million for 2025 on $32.4 billion in revenue.
The operating loss amounted to 2.1% of the company's revenue.
The Pittsburgh-based company reported a $209 million operating loss for 2024 on $29.4 billion in revenue. The 2024 loss amounted to 0.7% of 2024 revenue.
The star: If insurance company executives sound more excited about their dental insurance businesses than about their previously more glamorous major medical insurance and stop-loss businesses, that could be because the dental insurance units are the units still making money.
Highmark owns United Concordia, a dental insurer with 11.7 million enrollees.
The United Concordia unit reported an $88 million operating profit for 2025 on $1.8 billion in revenue, compared with an $105 million operating profit on $1.7 billion in revenue in 2024.
United Concordia's operating profit amounted to 4.9% of its revenue.
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