Medical Stop-Loss Premiums Up Nearly 10% for 2022

Specific deductibles: which is most common and what’s the range?

The most common specific deductible, which 10 percent of plans have, is $250,000. That’s up from $200,000 in the 2021 dataset.

However, specific stop-loss deductibles continue to vary widely, as illustrated below.

What’s the relationship between deductibles and premiums?

Average per-participant premiums are higher at lower specific stop-loss deductibles.

Interested in more data about stop-loss coverage?

Download our infographic to find out:

• The median deductible
• The percentage of plans that purchased broad coverage for medical and prescription drug claims
• Factors that affect a plan’s premium and premium increases
• The percentage of plans that stayed with the incumbent insurer when they bid or renewed their stop-loss coverage

Why get stop-loss coverage?

High-cost claimants with $100,000+ paid annual claims over the last two years accounted for less than 1 percent of all claimants but 28 percent of total medical plan claim expenses, according to SHAPE, our medical claims data warehouse.

As the number and value of high-amount healthcare claims continues to grow, stop-loss coverage provides important asset protection and cost predictability, particularly for self-funded plans, smaller groups and those with modest cash reserves.

The fact that a growing number of drug therapies can exceed $1 million annually in Rx paid claims for a single individual underscores the value of stop-loss policies that cover prescription drug claims.

If you have stop-loss coverage, are you sure it’s adequate?

The rapid rate of change in newly approved medical technology and procedures requires a close inspection of the coverage language offered by each stop-loss insurer. Segal subject matter experts carefully review stop-loss contract provisions to make sure policy language aligns with a plan’s coverage needs, so sponsors can secure coverage that meets their expectations.