The medical stop-loss market is approaching a significant inflection point, shaped by reinsurer exits, deteriorating underwriting performance and years of competitive pricing that can no longer be sustained. Skyward Specialty's Phillip C. Giles, CEBS, offers an in-depth look at the structural forces reshaping the market and what self-funded employers should do now to prepare.
Key takeaways include:
- Why two major reinsurer exits, removing an estimated $1.5 billion in market capacity, signal more than a routine market cycle
- Why an 86% industry-wide gross loss ratio in 2024, and 2025 results tracking north of 90%, are forcing a return of pricing discipline.
- The role of cell and gene therapies, specialty pharmaceuticals and No New Laser contracts in accelerating underwriting deterioration
- What self-funded employers should expect as carriers tighten underwriting, reduce renewal protections and scrutinize claims more aggressively
- How strategies like PBM transparency, infusion site-of-care management, indexed deductibles and captives can help employers manage rising costs
Read the full white paper for more insights and takeaways to help you stay ahead.