As health care costs continue to rise and employers look for greater control over benefit spending, self-funding has surged in popularity. However, with that shift comes a critical backstop: stop-loss insurance for self-funded employers and MEWAs.

In 2026, market volatility, escalating hospital costs, and the rapid growth of high-cost specialty drugs have significantly changed the risk landscape. Unpredictable catastrophic claims now make choosing the right stop-loss structure — and the right partner — more important than ever.

What Is Stop-Loss Insurance?

Stop-loss insurance protects self-funded employers from large, unexpected medical claims. When claims exceed a predetermined threshold (the deductible), the stop-loss carrier reimburses the employer for covered losses.

There are two primary types of coverage:

• Specific stop-loss: Protects the plan against high-cost individual claims by setting a per-member deductible. Once that deductible is met, the carrier reimburses the plan sponsor for covered expenses.
• Aggregate stop-loss: Protects the plan as a whole by capping total annual claims liability if overall claims exceed expected levels.

Why Employers Need Stop-Loss in 2026

Several factors have made stop-loss coverage indispensable for self-funded employers:

• Specialty drugs now account for more than 50% of pharmacy spend and over 30% of all stop-loss claims
• Catastrophic claims, including NICU care, cancer treatments, and organ transplants, continue to rise
• Health care inflation is projected to remain between 7% and 9%

Without properly structured stop-loss coverage, a single large claim can materially disrupt an employer’s financial stability.

Why Choose HCP National for Stop Loss Insurance

Effective stop-loss placement requires more than access to carriers — it requires expertise, independence, and advocacy. HCP National differentiates itself by:

• Marketing cases broadly across the stop-loss marketplace
• Engaging independent legal counsel with deep stop-loss expertise to review policies, identify exclusions, and negotiate improved contract terms
• Operating as an independent brokerage that does not steer business toward preferred carriers
• Bringing more than three decades of experience and over $1 billion in stop-loss premium placements
• Applying actuarial methodologies to help clients determine appropriate deductibles
• Being the only certified minority- and woman-owned brokerage in the stop-loss space (MBE and WBENC)
• Maintaining BBB A+ accreditation and a 4.8-star Google rating

Conclusion

Stop-loss insurance is not a commodity. Policy language, coverage definitions, and structural design materially impact outcomes. In 2026, the right broker does more than place coverage — they help protect and stabilize employer health plans in an increasingly volatile environment.