Stop loss insurance is the financial backstop self-funded employers purchase to cap their exposure to catastrophic claims. Adoption tracks closely with firm size: roughly 90% of mid-size large firms (200 to 4,999 workers) carry stop-loss coverage, though adoption drops to about 53% among the very largest employers (5,000-plus workers), per industry benchmarking data.
The market has been under real strain: total stop-loss premium volume reached nearly $40 billion in 2024, a 12.4% increase over 2023 alone, while gross loss ratios climbed to 85.8%—the highest on record for the industry—per Guy Carpenter and Oliver Wyman's Fall 2025 Stop Loss Market Update.
That strain flows directly back to the employer at renewal: a stop-loss carrier prices next year's premium based on this year's claims experience, so a bad claims year shows up in the very next quote. Reducing avoidable claims before they happen, through on-site care like the OnMed CareStation®, is one of the few levers an employer controls directly heading into that renewal conversation.
Some stop loss carriers offer a 1% renewal reduction for employers deploying on-site care solutions, reflecting the lower downstream claims trajectory that proactive chronic care management and ER diversion produce.
Specific stop loss caps an employer's exposure on any single large claim above the attachment point. Aggregate stop loss caps total plan cost across all claims combined for the plan year.
Stop-loss insurer premium volume reached $31.6 billion in 2022, a 13.4% increase from 2017-2022, according to an Oliver Wyman analysis, growth driven by rising claims costs and continued migration to self-funded plans.
Every term here points to the same gap in healthcare access. See how the CareStation closes it.
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