How to Size Your Stop-Loss Specific Deductible
The specific deductible is the most important stop-loss decision you'll make. Use our calculator to model the right range for your group, then use the guidance below to understand the tradeoffs.
Stop-Loss Sizing Calculator
Enter your employee count, claims PEPM, and risk tolerance to get a recommended specific deductible range and aggregate attachment point.
Open the Stop-Loss Sizing CalculatorThe 3–5× PEPM rule of thumb
A common starting point for specific deductible sizing is 3–5× your average monthly claims PEPM (per employee per month). For example, if your average monthly claims are $500 PEPM, a reasonable specific deductible range is $1,500–$2,500 per month × 12 = $18,000–$30,000 annually. Most groups end up in the $75,000–$200,000 range.
Larger groups can typically absorb higher deductibles because they have more members to spread risk across. Smaller groups should set lower deductibles to limit exposure from a single catastrophic claim.