State Legislative/Regulatory News

Self-Insurance Institute of America, Inc.

Exclusive Reporting for the Week of May 22, 2014

May 22, 2014 — This is your weekly update of state legislative/regulatory developments affecting companies involved in the self-insurance/alternative risk transfer marketplace. Should you have any questions on information provided in these reports and/or would like to alert SIIA to new state legislative/regulatory activity (health care, workers’ compensation and/or captive insurance matters) we may have missed, please contact Adam Brackemyre, Director of State Government Relations directly at 202/463-8161, or via e-mail at

Washington DC- Stop Loss Legislation Introduced
SIIA is working to change recently-introduced DC City Council legislation that would enact minimum stop-loss attachment points.

The “Federal Reform Implementation and Omnibus Amendment Act” is bill number B20-0797 and stop-loss insurance details are in the final pages. As proposed, the minimum stop-loss individual attachment point would be $40,000 and the aggregate attachment point must be greater than one of the following:
• $5,000 per group member
• 120% of expected claims
• $40,000
Also, there is a line that appears to require small groups to have a fully-insured health benefits plan in order to purchase stop-loss, “An insurer shall not issue or deliver to a small employer…a stop-loss insurance policy unless the employer has a fully-insured employee health benefit plan.”

As proposed, the legislation does not permit grandfathering of current policies, allow any employee or dependent to be excluded for reasons relating to “health status” or cancel or choose not to renew a stop-loss policy. The legislation would be effective after approved by the Mayor and reviewed by Congress.

SIIA has begun working with member and allies to have the stop-loss section removed from the legislation.

New York – Stop Loss Legislation
SIIA is making some progress in New York State to pass essential legislation to protect a segment of the self-insurance marketplace in that state.

SIIA’s retained counsel has been speaking to high-level Assembly Insurance Committee staff about have legislation introduced in that chamber. These discussions are ongoing and have continued this week.

Once there is Assembly legislation, SIIA will need clients to contact their Assembly members and encourage them to be supportive of the effort.

SIIA has initiated an integrated advocacy strategy including the mobilization of numerous SIIA members who are engaging their smaller self-insured clients in New York to communicate the urgency of this legislation to their elected representatives.

Member companies already actively engaged in the grassroots lobbying effort include Berkley A&H, Lawley Benefits Group, Sun Life, HCC Life Insurance Company, East Coast Underwriters, Standard Insurance, Meritain Health, Relph Benefit Advisors and Gerber Life Insurance.

Please contact Adam Brackemyre right away if you would like to participate as part of this grassroots strike team. Thank you again to everyone who is already helping.

SIIA’s 34th Annual Conference
SIIA’s National Conference and Expo is scheduled for October 5-7, 2014 in Phoenix, AZ, which will feature a dedicated Legislative/Regulatory/Legal update session. Conference details, including registration forms, can be accessed on-line at, or by calling 800/851-7789