Earlier this year, Milliman surveyed 32 employer stop-loss market participants about their business. The survey included eight of the largest 10 carriers in 2023 by written premium. The report reveals that administrative-services-only (ASO) carriers appear to have higher close ratios, higher persistency, and lower decline ratios than third-party carriers and managing general underwriters (MGUs). Predictive modeling algorithms are also more prevalent, although still not used by a majority of carriers. Our survey focused on various topics, including:  

• Portfolio characteristics
• Underwriting measures
• Sales/Distribution
• Pricing
• Portfolio results
• Product characteristics
• Level-funded product
• High-cost pharmacy and gene therapy treatments
• Carrier concerns