The Stop-Loss Renewal Decoder

Stop-loss claims grow about twice as fast as medical trend.

Specific stop-loss pays the part of each person’s claims above a fixed deductible. When claims rise, the deductible stays put, so the part above it grows faster. At Segal’s projected 9.9% medical trend for 2027, the claims a stop-loss carrier pays grow about 20%. Oliver Wyman measured 21.3% growth in claims above $100,000 from 2023 to 2024. This effect is called leveraging. It explains why stop-loss premiums rose 13.6% to 15.9% in 2026, depending on the deductible, even for groups whose claims did not change.

Why it matters:
Leveraging explains much of a stop-loss renewal, but not all of it. The rest comes from the carrier’s view of your claims, from lasers that shift large claimants back to the plan, and from the carrier’s own pricing and margin. Those are the parts to negotiate, and most employers cannot see where one ends and the other begins. With January renewals being finalized now, knowing which parts of an increase are justified matters before the contract is signed.

Data sources and scope:
The market benchmark comes from the 2026 Medical Stop-Loss Premium Survey by Aegis Risk and the International Society of Certified Employee Benefit Specialists, covering 1,378 plan sponsors, as published by the International Foundation of Employee Benefit Plans. It is checked against the Stealth Partner Group (Amwins) 2025 State of the Market report. Trend assumptions come from Segal and Mercer, large-claim frequency from Lockton, and market loss ratios from Oliver Wyman. This is an illustrative model, not underwriting. Actual renewals depend on a group’s own claims, large claimants, and plan design.

How to use the tool:
Enter your current and renewal specific stop-loss terms: the deductible, the contract basis, and the premium per employee per month. You can enter a composite premium or the rates by tier from your proposal. Add any lasers, aggregating specific deductible, or aggregate coverage. The report tells you whether the renewal is justified, explains why, and lists your negotiating points in dollars. It also prices other deductible options, including what the plan would pay in a bad year. Everything is calculated in your browser; nothing you enter is sent or stored. Use Print or save as PDF to keep a copy.