State Legislative/Regulatory News

Self-Insurance Institute of America, Inc.

Exclusive Reporting for the Week of October 30th, 2014

October 30th, 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

DC- Stop-Loss Legislation
On Tuesday, October 28th, the omnibus legislation containing new stop-loss limitations advanced another step into becoming law. The full DC Council passed the bill on its first reading. One additional reading and the bill will become law.

As previously reported, SIIA and other stakeholders testified at a public hearing and met with Department of Insurance Securities and Banking (DISB) staff responsible for writing the legislation and submitted amended language and justifications for those amendments, per DISB staff request.

Yesterday, Councilwoman Yvette Alexander introduced two amendments. The amendments were opposed by the Chairman, who cited the Department of Insurance, Securities and Banking’s support for the legislation. A strong majority of DC Council followed the Chairman’s lead and opposed the amendments. It should be noted that no public oral or written testimony could be submitted to support the amendments.

SIIA will continue to work with stakeholders and Council Members to improve the legislation, which contains a minimum $40,000 individual attachment point and effective prohibition on employers of 50 and fewer from purchasing stop loss.

Connecticut- Exchange Funding
SIIA is paying close attention to discussions in Connecticut concerning funding that state’s insurance exchange.

Recent exchange board minutes reveal that the Connecticut exchange board is beginning to consider sustainable funding sources. Connecticut law gives the exchange the ability to assess fully insured health and dental plans that are capable of being offered on the exchange. In addition, the law gives the exchange the ability to “…otherwise generate funding necessary to support the operations of the Exchange and carry out its purposes as set forth under Connecticut law.”

SIIA is working with individuals in Hartford to see what specific additional revenue-raising measures are being discussed, if any. As you may recall, SIIA defeated a stop-loss insurance assessment earlier this year and will defend stop loss from any new assessment.

New York- Grassroots Support for Fixing the Stop Loss Law
One SIIA member met with two of his clients this week, encouraged them to contact their Assembly Members to support changing the state’s stop-loss law and handed them SIIA-drafted template letters to make advocacy easy for them.

This summer, the New York State Assembly Insurance Committee Chairman told SIIA’s retained state lobbyist that support from the business community is critical to passing this legislation.

While SIIA is working with members, interested parties and stakeholders to fix the state’s stop loss law. As you recall, “small employer” cannot purchase stop-loss in New York State. On January 1st, 2016, the state’s definition of small employer will increase from 50 to 100- and so will the stop-loss ban.

Legislators need to hear from their constituents as soon as possible. If you have clients with 51 to 100 covered lives, please contact Adam Brackemyre, SIIA’s Director of State Government Relations, at He can provide you or, if you prefer, your client, with any information or template letter that you or your client may need.