Reflects Increased Pricing Discipline which Likely Continues into 2027
Medical stop-loss premiums in 2026 show an increase from 13.6% on a $100,000 deductible to 15.9% on a $750,000 deductible, as reported by the 2026 Aegis Risk Medical Stop-Loss Premium Survey, cosponsored by the International Society of Certified Employee Benefit Specialists. Notably, this increase is approximately 5% to 5.5% higher than increases seen for the previous 2025 renewals. This impact was not surprising, as many underwriters reported increased severity and frequency in stop loss-claims in late 2024 and a resulting erosion in claims-to-premium loss ratios thereafter and throughout 2025. The survey captured necessary correction to 2026 premiums. The measured increases, rising alongside the size of deductible, reflect leveraged medical trend, as the underlying growth in expense of a catastrophic medical claimant is fully borne by an unchanged deductible.
Survey response uniquely captures final, negotiated premium and reflects any pricing improvement from renewal marketings and concessions across all deductibles. In comparison, several large direct underwriters reported an average 2026 increase in the low 20% range on their own book-of-business. However, those are weighted by in-force policies unable to locate lower cost alternatives. The comparatively lower increases observed in this survey reflect the 2026 renewal rate opportunity found in the market. Looking ahead, an ongoing return to underwriter discipline and need to restore insurer loss ratios to a more profitable position does not indicate any easing on the 2027 renewal cycle.
Stop-loss insurance protects self-funded health plans against large and unpredictable liability that can arise when one plan participant, or claimant, has significant medical expense beyond a specified deductible (known as specific or individual stop-loss) or when a higher frequency of overall claims occurs in the aggregate (known as aggregate coverage). Individual stop-loss coverage deductibles often correlate to the size of covered employees and risk tolerance of the plan sponsor, ranging from as low as $50,000 for smaller groups to as high as $1 million or more per covered participant per policy year for those much larger. The survey further shares respondent deductibles by the number of covered employees.
Since individual stop-loss deductibles vary, the average monthly premium per covered employee similarly varies. According to the survey, the average monthly premium per covered employee at a $100,000 deductible is $260.63; at a $500,000 deductible, it is $58.82. At a $1,000,000 deductible, the premium lowers to $20.71. For this survey, all contracts are equated to a mature paid contract. A paid contract will cover all claims that are paid during the 12-month policy period regardless of when claims are incurred. For aggregate stop loss, the median monthly premium per covered employee is $7.93.
The 2026 Aegis Risk Medical Stop-Loss Premium Survey was done in partnership with the International Society of Certified Employee Benefit Specialists (ISCEBS). It measured data from 1,378 plan sponsors covering over 1,400,000 employees with more than $1.5 billion in annual stop-loss premium. The survey further measures additional stop-loss policy provisions, including aggregate stop-loss, individual stop-loss deductible size by employee size, contract type and the presence of renewal exclusions or lasering.
