SJVIA approves 2025 stop‑loss reinsurance renewal; board to weigh captive options for 2026

The San Joaquin Valley Insurance Authority voted on May 20 to ratify the stop‑loss reinsurance in place for plan year 2025 and discussed strategies for the 2026 renewal, including exploring captive market options and lower attachment points.

Consultants and board members revisited recommendations from the April strategic planning session about the SJVIA’s reinsurance attachment level. A consultant reported the current stop‑loss attachment is $475,000 for the pooled self‑funded program and noted that while that level may be appropriate for the pooled SJVIA, it can be high for individual participants such as Fresno or Tulare counties. The presenter said high‑cost claims in County Tulare are frequently below the group stop‑loss threshold and thus do not trigger stop‑loss payments, effectively “hiding” costs within county experience.

At the meeting the board approved the existing 2025 stop‑loss reinsurance arrangement. The board also directed staff and consultants to evaluate options for the next renewal, including captive-market solutions to lower the attachment range — for example, exploring options to move the effective attachment from roughly $475,000 toward lower levels such as $200,000–$300,000 for certain layers — and to consider additional risk‑management programs for high‑claim members.

Why it matters: attachment points and the structure of stop‑loss coverage determine how much catastrophic risk the pooled plan retains versus transfers to the market. Adjusting attachment levels or entering a captive could shift costs between participating counties and affect premiums or stabilization funding.

Board action: motion to approve the 2025 stop‑loss reinsurance renewal passed at the meeting.