The 2025-2026 Stop-Loss State Of The Union

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Self-Funded With Spencer

Spencer Smith

245 episodes

5 days ago

Self-funded with Spencer shares inspiring conversations with the most successful and influential people in healthcare - company founders, CEOs, entrepreneurs, doctors, sales leaders, and more - to help educate and inspire YOU to become the best version of yourself.

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The 2025-2026 Stop-Loss State Of The Union | with Jay Ritchie

Self-Funded With Spencer

1 hour 30 minutes 57 seconds

2 weeks ago

The 2025-2026 Stop-Loss State Of The Union | with Jay Ritchie

“I absolutely think we're in that tightening, hardening market... the days of the employers who were average risk seeing single digit rate increases, that's gone. It's going to be a double digit rate increase market going forward." - Jay Ritchie

The president of one of the largest stop-loss carriers is here to deliver the State of the Union for our market. My guest this week is Jay Ritchie, President of Tokio Marine HCC, and he shares the current state of the market and what to expect for 2025-2026 renewals.

Jay breaks down the trends his team is seeing, including the explosion of multi-million dollar claims driven by NICU stays and new gene therapies. We discuss why industry-wide loss ratios have jumped, how the post-COVID "rebound" is impacting rates, and why the core stop-loss product has remained unchanged while the innovation now centers on risk measurement.

But the conversation isn't all negative; we also discuss the path forward. We explore why data is the future of underwriting, how active risk management through captives creates stability in a volatile market, and why treating your stop-loss carrier as a partner, not a commodity, is more critical than ever.

Tune in for the State of the Union for our industry as we head into 2026.

Chapters:

(00:00:00) The 2025-2026 Stop-Loss State Of The Union

(00:06:18) A 40-Year Career in Stop-Loss

(00:21:33) The Explosion of Million-Dollar Claims Post-ACA

(00:40:26) Why Loss Ratios Are Climbing Across the Industry

(00:55:40) How Captives Create Stability in a Hard Market

(01:07:07) Partner vs. Commodity: The Future of Stop-Loss

(01:29:02) Why Data is the Future of Underwriting

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