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State laws barring stop-loss policies with low attachment points are not preempted by ERISA, the U.S. Department of Labor said in Technical Release 2014-01. Ten states have passed such laws, many of them since the advent of the Affordable Care Act. When small groups self-insure, they are subject to proportionately larger impacts from particular expensive claims, have […]
Legislation designed to make it more difficult for smaller employers to self-insure by restricting their ability to obtain stop-loss insurance with very low attachment points was signed into law on Oct. 1 by California Gov. Jerry Brown. S.B. 161, which takes effect Jan. 1, 2014, will prohibit stop-loss insurers in California from issuing policies with specific […]
Fast-moving events have advanced state-level proposals aimed at regulating stop-loss, which would make it more expensive for small employers to self-insure health benefits, and put power over self-funding in the hands of state insurance commissioners. Utah law now requires stop-loss insurers to cover incurred and unpaid claims if a small employer plan terminates — an unprecedented requirement. […]
The health reform law provides that entities called “Navigators” will assist consumers and small businesses in researching health insurance exchanges — but stop-loss insurers for self-funded health plans won’t be one of them. Those insurers, as well as individuals and other entities with too close a financial relationship to such insurers, would be excluded from […]
In a May 18 ruling, the Texas Supreme Court compelled a stop-loss insurer to pay a direct premium tax on stop-loss policies sold to self-funded health plans. Stop-loss insurance written in Texas for self-funded plans is not “reinsurance” and thus must pay state levies and follow state insurance rules, the court held. American National, a […]
The federal government seems to be fishing around for evidence showing that self-insured health health plans will siphon off healthy lives from state-run insurance exchanges (a cornerstone of reform). On April 26, the U.S. Departments of Labor (DOL), Health and Human Services (HHS) and IRS/Treasury issued a set of questions about the use of stop-loss […]