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Ceded US health insurance premiums hit $203B as reinsurers expand
AM Best said stop-loss and excess-loss premiums jumped 50% year over year to $19.6 billion in 2025, reflecting insurers’ push to manage medical cost volatility.
Over the past decade, the amount of ceded US health insurance premium flowing into the reinsurance market has surged more than 300%, reaching $203 billion in 2025 from $59 billion in 2016, according to an AM Best report on the global reinsurance industry.
AM Best attributed the acceleration to insurers seeking capital efficiency and additional support as underwriting margins across US health segments face pressure from volatile medical costs, larger claims exposure, and demands to reduce earnings volatility.
The report highlighted the role of catastrophic-claims coverage, noting that premiums ceded for stop-loss and excess-loss protection rose 50% year over year to $19.6 billion in 2025.
AM Best also pointed to ongoing cost headwinds for healthcare, including rising labor and supply expenses, an aging population, new high-cost specialty medications, and changes affecting Medicare Advantage and Medicaid managed care, while projecting reinsurance use would likely remain part of insurers’ capital management strategy even if trends stabilize.