Reports and Surveys | June 8, 2026

Medical Stop-Loss Premiums Increase Nearly 13%

By Michael S. Tesoriero

Rate of increase in medical stop-loss premiums has accelerated. For the 225 health plans in Segal’s 2027 national medical stop-loss dataset, the average stop-loss coverage premium increase is 12.7 percent, up from 9.7 percent.

The average is for groups that maintained similar specific stop-loss benefit levels as the prior year.

Among all groups, including those that increased specific stop-loss deductible levels and/or aggregating specific stop-loss deductibles resulting in an overall reduced rate action, the average premium increase is 11.5 percent, up from 7.3 percent.

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Medical Stop-Loss Premiums Increase Nearly 13 Percent Download Now

Get additional current data on medical stop-loss insurance

You’ll learn:

  • The percentage of plans that purchased broad coverage for medical and prescription drug claims
  • The wide range of specific stop-loss deductibles
  • Which deductible is most common
  • The median deductible
  • Median monthly per-participant premiums, which typically are higher at lower specific stop-loss deductibles, for three deductibles
  • Six factors that affect a plan’s premium and premium increases

2026 Stop Loss infographic thumbnail

Why group health plans need stop-loss coverage

What were once rare “shock claims” are now recurring events. The number of claimants with seven-figure claims has grown an average of 25 percent per year over the last four years, based on trends observed in SHAPE, Segal’s 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 some drug therapies cost more than $3.5 million 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.

Have questions about medical stop-loss coverage?

To discuss the adequacy and competitiveness of your plan’s stop-loss coverage compared to plans in Segal’s 2025 dataset, get in touch.

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Medical Stop-Loss Premiums Increase Nearly 10%

Segal’s infographic based on the latest medical stop-loss coverage data shows how health plan sponsors are protecting against rising medical costs.

Health, Multiemployer Plans, Public Sector, Healthcare Industry, Higher Education, Architecture Engineering & Construction, Corporate, Pharmaceutical

Get the Infographic

This page is for informational purposes only and does not constitute legal, tax or investment advice. You are encouraged to discuss the issues raised here with your legal, tax and other advisors before determining how the issues apply to your specific situations.