Enter your stop-loss renewal to see whether the increase is justified, why, and where to negotiate. The report tests the renewal against leveraging, market pricing, and the carrier's margin, then prices your deductible options.
Specific stop-loss pays the part of each person's claims above a fixed deductible. When claims costs rise, the deductible stays the same, so the part above it grows faster than claims overall. For example, a $160,000 claim on a $100,000 deductible leaves $60,000 for the carrier. If that claim grows 8.5% to $173,600, the carrier's share grows to $73,600, an increase of 23%. Across a whole group, more people also cross the deductible each year. This effect is called leveraging, and it is why stop-loss premiums rise faster than medical trend even when nothing about the group has changed.
Enter your specific stop-loss coverage as it is today and as quoted at renewal. Premiums are per employee per month (PEPM) for specific coverage only, not aggregate. Everything is calculated in this browser window; nothing you enter is sent or stored.
Enter the census and the specific rate for each coverage tier, as shown on the proposal. The tool calculates the composite premium per employee per month and the employee count from them.
A laser gives one person a higher deductible than the rest of the group, or excludes them. Projected claims come from your TPA's large claimant report; if you leave it blank, the tool assumes the person reaches the laser.
Enter specific premiums without the terminal liability option (TLO) or aggregate premium. Use the trend the carrier is likely pricing with, not your plan's own recent trend; it defaults to Segal's 2027 projection (9.9%), and the carrier can tell you theirs. Expected loss ratio is the share of premium a carrier expects to pay out in claims; 80% is a typical pricing target. Both are explained in section 8. The market benchmark includes pharmacy claims; every plan in the survey covers Rx alongside medical.
The market benchmark comes from the 2026 Medical Stop-Loss Premium Survey by Aegis Risk and the International Society of Certified Employee Benefit Specialists (ISCEBS), which covers 1,378 plan sponsors and more than 1.4 million employees. As published by the International Foundation of Employee Benefit Plans, the average 2026 specific premium on a paid contract was $260.63 PEPM at a $100,000 deductible and $58.82 at $500,000. Those two points define a curve in which premium falls by about 47% each time the deductible doubles. The same curve reproduces the survey's published premiums at every deductible from $100,000 to $750,000. Premiums for other contract bases are adjusted with the survey's contract factors (for example, a 12/12 contract costs about 19% less than a paid contract because it covers fewer months of claims).
Stop-loss pricing varies by carrier and by book of business. The Stealth Partner Group (Amwins) 2025 State of the Market report shows premiums by deductible band for a book that is 77% 12/12 contracts. Its premiums sit close to the survey's paid-contract level, which puts them roughly 5% to 24% above the survey on a like-for-like contract basis, depending on the deductible. The tool therefore shows a market range from the survey level to 24% above it. Both sources show the same rate of decline as deductibles rise.
Every plan in the 2026 survey covers pharmacy alongside medical, so the market range reflects medical and Rx coverage. No public source quantifies how much lower a medical-only premium runs, so for medical-only coverage the tool still shows the range but notes that a fair medical-only premium should sit below it. The leveraging math applies to either. When Rx is covered, a medical trend that blends in the higher pharmacy trend (Segal projects 11.5% for Rx in 2027) is more realistic.
Aggregate stop-loss is priced separately from specific coverage and does not lower the specific premium. The aggregate benchmark comes from the same 2026 survey: a median of $12.21 PEPM when the specific deductible is $250,000 or less, $4.03 PEPM at higher deductibles, and $7.93 overall.
An aggregating specific deductible is part of specific coverage, not aggregate coverage. The plan pays an extra corridor of claims above the specific deductible, combined across all claimants, before the carrier starts reimbursing. Stealth Partner Group reports that 27.5% of its groups elected one in 2025 and that it lowered specific premium by 14.2% on average. The tool estimates the cost of the corridor by simulating claims above the specific deductible for an average-risk group.
Survey premiums include broker commissions, so a quote net of commission should sit below the market range. Plans that use reference-based pricing or a narrow network cap what they pay for large hospital claims, and carriers price them lower. No public source quantifies either effect, so the tool notes them rather than adjusting the range.
Leveraging depends on the trend the carrier uses to price the renewal, which is usually a market trend rather than the plan's own recent experience. The default is Segal's 2027 projection of 9.9% for medical plans; Mercer projects 8.2% after plan changes. Ask the carrier which trend it used.
A laser shifts claims back to the plan, so the renewal premium understates the cost of the renewal. For each laser the tool estimates the extra claims the plan keeps: the person's projected claims up to the laser amount, minus the group deductible. If no projection is entered, it assumes the person reaches the laser. That cost is added to the premium to show the effective renewal. In the 2026 survey, 19% of respondents had at least one lasered claimant; Stealth Partner Group reports 29% of its groups in 2025.
The curve implies that the number of people whose claims exceed a deductible falls in a consistent pattern as the deductible rises. Under that pattern, when all claims grow by a trend rate t, claims above a fixed deductible grow by (1 + t) raised to the power 1.92, or roughly twice the trend rate. At 9.9% trend that is about 20%, consistent with Oliver Wyman's measured 21.3% growth in claims above $100,000 from 2023 to 2024.
Expected claims above a deductible are estimated as the market premium times the expected loss ratio, assuming an average-risk group. At an 80% loss ratio this implies about 11 people per 1,000 members with claims above $100,000, in line with Lockton's 2025 finding of about 1% of members. The 1-in-10 year figures come from 20,000 simulated plan years: claimant counts follow a Poisson distribution and claim sizes follow the same curve.
Typical deductibles, laser rates, and no-new-laser/rate-cap rates by group size come from the Stealth Partner Group (Amwins) 2025 State of the Market report, based on its book of business of about 2,900 groups. Aggregating specific deductible figures come from the same report.
This is an illustrative model, not underwriting. Actual renewals depend on your group's claims experience, known large claimants, lasers, industry, location, network, and each carrier's appetite. Expected claims assume an average-risk group. Results outside the survey's $100,000 to $750,000 range are extrapolated and less reliable. Survey premiums include broker commissions.
Prepared by Datavoce Consulting, LLC. For informational purposes only; not actuarial, legal, or insurance advice.