What’s New for Physician Insurance in 2025

Authored by Mike Madey, Senior Vice President, and Sean Dauber, Senior Vice President

Property & Casualty

For better or for worse, the answer is… not much. Through the first half of the year, we have seen mainly a status quo in the physician market across the country. Most carriers are taking small rate increases, with some additional underwriting in the familiar “hot spots,” but overall, it’s essentially a mirror image of 2024.

As we move into 2026, all indications point to more of the same. Physician carriers are still recovering from a prolonged period of underwriting losses. While they are back in the black (or close to it), there have been few new entrants to the market causing any significant shake-up—other than Indigo.

Regarding other lines of coverage for physician groups, here’s what we are seeing:

• Property & General Liability (BOP): Continued excellent pricing; however, coastal property remains difficult to place, mainly staying within the Excess & Surplus lines space.
• Management Liability: Adequate market space for the physician sector, with many carriers attracted to this vertical.
• Cyber: Aggressive pricing for groups with controls in place (MFA is a must).
• Auto: Tight pricing and limited market access for small fleets. If you have a fleet of personal autos for physicians, we have been recommending rolling them onto personal lines policies.

Employee Benefits – Now that’s a different story

The massive budget reconciliation bill, known as the One Big Beautiful Bill Act (OBBBA), was signed into law by President Trump on July 4, 2025. The nearly 800-page bill incorporates many aspects of tax, defense, and energy policies, including several changes affecting employee benefits. Notably, these changes impact health savings accounts (HSAs), dependent care assistance programs (DCAPs), and Direct Primary Care (DPC).

OBBBA Impact on HSA plans

Telehealth

• During the pandemic, individuals were allowed to maintain HSA eligibility even when their high-deductible health plan (HDHP) waived deductibles for telehealth. Starting with plan years beginning in 2025, telehealth may be offered with no cost-sharing without affecting HSA eligibility.
• The OBBBA has now made this relief permanent, retroactive to the beginning of 2025—when the relief expired for calendar-year plans. Coverage for telehealth and other remote care services available with reduced or no cost-sharing will not impact individuals’ eligibility to contribute to an HSA.

Direct Primary Care (DPC)

• Beginning in 2026, certain DPC arrangements may be offered with no member cost-sharing without affecting HSA eligibility.
• HSA funds can now be used to reimburse any fees paid for such arrangements.
• Participation in DPC arrangements that meet the following requirements will not cause a loss of HSA eligibility:
  • The DPC must involve a fixed monthly fee, not exceeding $150/month for an individual or $300/month for more than one individual (subject to annual indexing).
  • The DPC must involve medical care provided by a primary care practitioner. Procedures requiring general anesthesia, prescription drugs (other than vaccines), and laboratory services not typically administered in an ambulatory primary care setting do not qualify as primary care.

TIP! Fees paid for DPC arrangements are treated as eligible medical expenses for HSA reimbursement.

OBBBA Impact on Dependent Care Plans (DCAPs)

• Starting in 2026, the maximum annual reimbursement limit will increase from $5,000 to $7,500 (or $3,750 for married individuals filing separately).
• This amount is still not indexed for inflation, so it will remain at $7,500 until Congress changes the limit again. The $5,000 limit was first established in 1986, so after 40 years, this change is long overdue.

TIP! With the higher limit now set at $7,500, it may be more challenging for some employers to pass the non-discrimination testing specific to DCAPs.

Maximum Out-of-Pocket (MOOP) Limits for 2026