奥纬咨询&佳达：2025年秋季止损保险市场动态更新报告（英文版）（33页）.pdf

1、STOP LOSS MARKET UPDATEFall 2025 Oliver Wyman and Guy Carpenter2Guy Carpenter and Oliver Wyman present our third annual joint Stop Loss Market Update.This newsletter includes reported annual statutory financial experience,market and cost trends and drivers,and a discussion of advanced predictive and

2、 AI analytical techniques.Our aim is to keep you abreast of key stop loss market trends and dynamics that impact stop loss insurer financial results and profitability.2019-2024 statutory financials resultsStop loss carrier premium volume increased to$39.0 billion in 2024,reflecting a growth rate of

3、11.2%from 2019-2024 with 10.0%of the annual growth attributable to cost trends and business mix changes,and the remainder due to increased enrollment.Claims increased at a faster rate than premiums resulting in loss ratios deteriorating from 81.6%in 2019 to 86.0%in 2024 with quite a bit of loss rati

4、o volatility in the interim years.Stop loss market trendsAs healthcare costs continue to rise and inflationary pressures persist,employers are adopting self-funding strategies to better manage their costs and overall healthcare spend.Over the past five years,enrollment in the fully insured group med

5、ical market has declined by almost 17%.High dollar claims trendsThe growing frequency of large claims has become a significant concern for insurance and reinsurance companies with claims over 1 million dollars steeply increasing in the past 5 years.All signs indicate that the frequency of claims exc

6、ess of 1 million will continue to grow in the upcoming year.These large claims can be attributed mainly to cancer treatments,premature births,complex conditions,and new high-cost pharmacy therapies.Optimizing advanced analytical approaches to improve stop loss performanceRising claim costs has place