MedBen recetly noted that matching national trend in 2027 still means absorbing a large increase. A Fortune article points to the forces behind another year of elevated growth, including expensive drugs, high-cost treatments, and AI-enabled medical billing. Those same forces are also hardening the stop-loss market.
- Providers are using AI tools to produce more detailed clinical notes. That extra documentation can support higher-paying billing codes even when the level of care has not changed.
- Pharmacy is compounding the problem. GLP-1s and specialty drugs — often more than half of pharmacy spend — are growing faster than medical trend.
- Claim severity at the youngest ages is producing more million-dollar-plus claims. Stop-loss data show that claim severity for children under age 1 is significantly higher than for other age groups, driven largely by neonatal and congenital cases.
“Larger and more frequent claims are putting intense pressure on stop-loss, and carriers are answering with higher-than-normal premium increasing compared to past years, increases in lasering, and tighter lock-in periods,” said Brian Fargus, MedBen’s Vice President of Sales & Marketing. “That makes it more important for self-funded employers to implement more risk-reducing solutions.”
To find out about many of the risk-reducing strategies that MedBen clients are implementing download our 2026 Client Report. You’ll see how these tools have helped employers beat trend and keep stop-loss risk more manageable.