Your broker says a $100,000 specific attachment point and a 125% aggregate are standard. Utah publishes the actual distribution every year, so you can check. Here is what the state's own 2024 stop-loss data shows, and what it says about your next renewal.
If your stop-loss renewal came back sharply higher this year, that is consistent with the market and not necessarily with your claims. Utah stop-loss carriers reported a 101.3 loss ratio in 2024 — paying out more than they collected, against a ten-year average of 83.6. Here is how to separate your increase from the market's.
Most employers never see a benchmark for this. The attachment points in a self-funded proposal arrive as settled facts, and the only comparison available is last year's own numbers. Utah is unusual: the Insurance Department collects stop-loss data from every carrier writing in the state and publishes the distribution. That makes it possible to check whether what you were handed is ordinary.
Everything below comes from the Utah Insurance Department's 2025 Health Insurance Market Report (published February 2026, covering calendar year 2024). If you want the mechanics of how stop-loss works rather than the benchmarks, start with attachment points, lasering, and what changes at 50 employees and come back here.
What does Utah's stop-loss market actually look like?
It is a small slice of the insurance market and a large part of how self-funded employers manage risk. Stop-loss made up 3.5% of Utah's commercial health insurance market in 2024, with 40 insurers covering 648,749 members and $391.1 million in direct earned premium.
Two things moved in 2024, in opposite directions. Member count fell about 10%, from 726,017 in 2023 to 648,749. Premium stayed essentially flat, $391.9 million to $391.1 million. The same premium pool spread across fewer members means premium per member went up, which is the arithmetic behind a lot of renewal letters.
Most of that market is employers your size or larger. Groups of 101 or more eligible employees accounted for 90.5% of stop-loss membership — 621,457 of the 648,749 covered members.
That concentration tracks how common self-funding has become. The KFF 2025 Employer Health Benefits Survey finds 67% of covered workers in self-funded plans overall and 80% at firms with 200 or more workers — and among covered workers in self-funded plans at those larger firms, 75% are in plans that carry stop-loss. At your size, stop-loss is not an exotic add-on. It is the layer that makes self-funding survivable.
What is the most common specific attachment point?
$100,000, and it is not close. Just over a fifth of all Utah stop-loss members — 22.2% — were in plans with a $100,000 specific attachment point in 2024. The next most common was $200,000 at 19.3%, then $300,000 at 11.9%. Those three levels together cover more than half the market.
The specific attachment point, also called the individual stop-loss deductible, is the dollar amount of claims for one covered person at which the carrier starts reimbursing your plan. Here is the distribution across the levels carrying real volume:
| Specific attachment point | Share of Utah stop-loss members (2024) |
|---|---|
| $50,000 | 6.5% |
| $100,000 | 22.2% |
| $200,000 | 19.3% |
| $300,000 | 11.9% |
| $500,000 | 7.2% |
| $700,000 | 5.6% |
| $1,000,000 | 7.7% |
| No specific coverage | 1.4% |
Smaller employers sit lower in that table, and the law beneath them has since changed — which matters if you are reading older benchmarks. The Department's 2024 data notes a then-current requirement that a small group stop-loss policy carry a specific attachment point of at least $10,000. That floor is no longer current. Utah Code § 31A-43-301, as amended effective 1 July 2025, now requires a small employer stop-loss contract to set the annual specific attachment point at no less than $25,000 and the annual aggregate at no less than 90% of expected claims. So the 2024 membership showing attachment points under $25,000 reflects contracts written under the old floor, and a small employer shopping today should not expect to see them.
The practical use of this table is narrow and real. If you are a 150-employee Utah employer and your proposal sets a specific attachment point of $300,000 or higher, you are retaining more risk per person than most of the market — and the lower fixed cost in the spreadsheet is what you are being paid to do that.
How common is aggregate stop-loss, and where is it set?
Less common than most employers assume. In 2024, 41.4% of Utah stop-loss members had no aggregate coverage at all. The report states it the other way round: 59% of membership included some kind of aggregate stop-loss, and the rest reported none.
Aggregate stop-loss protects against the frequency of claims rather than their severity — everyone being somewhat more expensive than projected, instead of one person being catastrophically expensive. It is expressed as a percentage of expected claims. An attachment point of 125% means coverage begins paying once claims reach 25% above the expected level.
Among Utah employers who bought it, the clustering is tight:
| Aggregate attachment point | Share of Utah stop-loss members (2024) |
|---|---|
| None | 41.4% |
| 100% to 104% | 7.2% |
| 115% to 119% | 4.6% |
| 120% to 124% | 30.4% |
| 125% to 129% | 9.2% |
| 130% or more | 0.2% |
So the familiar "125% aggregate" is near the market but slightly above it: 120% to 124% is more than three times as common. And in the 101-or-more band, 40.9% of members carried no aggregate coverage — the number worth sitting with, because an absent aggregate layer is rarely presented as a choice. It is usually just missing from the proposal.
Why is your stop-loss renewal going up?
Because the carriers lost money. The Utah stop-loss market reported a loss ratio of 101.3 in 2024, meaning more paid out in claims than collected in premium. That is the first year above 100 in the ten years the Department reports, and it follows 92.6 in 2023 and 89.0 in 2022 against a ten-year average of 83.6.
A market coming off three consecutive years of deteriorating loss experience raises prices on everyone, including employers whose own claims were fine. That is the part of your renewal no amount of good claims history will negotiate away, and separating it from the part that is about your group is most of the work at renewal. For context, the same report shows Utah's comprehensive health insurance premium rising from $429 per member per month in 2023 to $456 in 2024, a 6.3% increase — so this is not a stop-loss-only story.
Does your group size change the price?
Substantially. Premium per member per month ran more than twice as high for the smallest groups as for the largest, and the middle band had the worst claims experience in the state:
| Group size (eligible employees) | Share of market | Premium PMPM | Loss ratio |
|---|---|---|---|
| Small group (1–50) | 5.7% | $126 | 82.7 |
| Large group (51–100) | 3.8% | $94 | 120.0 |
| Large group (101 or more) | 90.5% | $57 | 101.7 |
If you have more than 100 eligible employees, you are in the band paying $57 PMPM and your benchmark is the 101.7 loss ratio, not the market-wide 101.3. Employers between 51 and 100 should expect a harder conversation: a 120.0 loss ratio in that band means carriers priced it badly and will be correcting.
The Department attributes the premium gap largely to attachment points — smaller groups buy lower specific attachment points, and specific coverage costs more than aggregate, so it accounts for more of the premium. Worth knowing before you read a low PMPM as a better deal.
What can these numbers not tell you?
They describe a market, not your quote. Four limits matter.
- The data is calendar year 2024, published February 2026. Your next renewal is being priced on more recent experience than this.
- It covers Utah-reported stop-loss business across all industries. Your industry, claims history and demographics can justify a position well outside the common distribution.
- The attachment point distribution is counted by member, not by employer, so the largest plans weight it.
- A common attachment point is not a correct one. The right specific attachment point is the largest single claim you can absorb without disrupting operations — a question about your balance sheet, not the market's.
This is general information, not legal, tax or actuarial advice. What any stop-loss contract actually covers turns on its own terms — contract basis, run-in and run-out, lasering and disclosure — and those deserve a careful read with an advisor who will show you the arithmetic.
What should you ask at your next renewal?
Five questions turn this data into leverage.
- What is our specific attachment point, and where does it sit in the Utah distribution? If it is above $300,000, ask what you are being paid to retain that much risk per person.
- Do we carry aggregate stop-loss, and at what percentage? If the answer is no, that should be a decision you made rather than a gap you discover.
- How much of our increase is the market and how much is us? Ask for the carrier's trend assumption separately from your own experience rating.
- Was any individual lasered at this renewal? A laser moves a known high-cost claimant outside your coverage and changes your real exposure without changing the headline attachment point.
- How many carriers were approached? With 40 carriers writing stop-loss in Utah and 72% of the market held by out-of-state insurers, a two-quote renewal is not a market test.
If you cannot answer the first two from your own file, that is the finding. A claims audit or a straight read of the stop-loss contract usually settles it faster than another round of quotes.
There is also a ready-made template for the answers. Utah requires small employer stop-loss insurers to use the Utah Stop-Loss Disclosure form, which asks the carrier to state both attachment points, the fixed costs, the claims the employer retains, and a total employer outlay at minimum, expected and maximum. You are above the size where it is mandatory, which is no reason not to ask for the same figures in the same shape.
What to do next
Pull your current stop-loss policy and find two numbers: the specific attachment point, and the aggregate percentage if you have one. Compare them to the tables above. If your position is unusual, the question is whether it was chosen deliberately. And if your renewal is up sharply while your claims were not, these numbers give you something concrete to push back with.
We work with employers across the Wasatch Front, including Sandy and the Salt Lake Valley. If you want a second read on your stop-loss terms, or on a renewal you are being asked to accept, get in touch.
Related reading: what stop-loss insurance is, how a self-funded plan works, fully insured vs level-funded vs self-funded, and how group captives pool stop-loss risk.
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