Home
+
About Us
Welcome Video
Company Overview
Our Purpose
A Message from our CEO
Testimonials
+
Leadership
Executive Team
Legal Team
Careers
Giving Back
Locations
Contact
Phia Certification
Diversity & Inclusion
Privacy Statement
Covid-19 Resources
+
Services
Learn - Independent Consultation & Evaluation
Plan - Phia Document Management
Plan - Plan Drafting Services
Save - Claims, Recovery & Subrogation Services
Save - Claim Negotiation
Save - Phia Unwrapped
Protect - Plan Appointed Claim Evaluator (PACE)
Protect - Patient Defender & Balance Billing
Phia International
-
Media
Covid-19
Webinars
Newsletters
Publications
Blog
Press Releases
Podcasts
Industry Terms
Guide to Understanding Subrogation
Moving To Self-Funded Health Plan Guide
Referenced-Based Pricing Explained
Hospital Price Transparency Guide
Balance-Billing: What Patients Need To Know
Employee Rights With COVID-19 Vaccines
The No Surprises Act Explained
Mental Health Parity and Addiction Equity Act Explained
Understanding Non-Quantitative Treatment Limitations (NQTLs)
The Insulin Cap Bill Offers Hope for Americans With Diabetes
+
Members Area
+
FAQs
FAQ - Subrogation & Reimbursement
FAQ - Mass Tort Subrogation & Reimbursement
Questionnaire Response
Make A Payment
888-986-0080
info@phiagroup.com
Questionnaire Response
Blog
Podcasts
|
Login
Home
About Us
Welcome Video
Company Overview
Our Purpose
A Message from our CEO
Testimonials
Leadership
Executive Team
Legal Team
Careers
Giving Back
Locations
Contact
Phia Certification
Diversity & Inclusion
Privacy Statement
Covid-19 Resources
Services
Learn - Independent Consultation & Evaluation
Plan - Phia Document Management
Plan - Plan Drafting Services
Save - Claims, Recovery & Subrogation Services
Save - Claim Negotiation
Save - Phia Unwrapped
Protect - Plan Appointed Claim Evaluator (PACE)
Protect - Patient Defender & Balance Billing
Phia International
Media
Covid-19
Webinars
Newsletters
Publications
Blog
Press Releases
Podcasts
Industry Terms
Guide to Understanding Subrogation
Moving To Self-Funded Health Plan Guide
Referenced-Based Pricing Explained
Hospital Price Transparency Guide
Balance-Billing: What Patients Need To Know
Employee Rights With COVID-19 Vaccines
The No Surprises Act Explained
Mental Health Parity and Addiction Equity Act Explained
Understanding Non-Quantitative Treatment Limitations (NQTLs)
The Insulin Cap Bill Offers Hope for Americans With Diabetes
Members Area
FAQs
FAQ - Subrogation & Reimbursement
FAQ - Mass Tort Subrogation & Reimbursement
Questionnaire Response
Make A Payment
Posts
Media
>
Posts
Covid-19
Webinars
Newsletters
Publications
Blog
Press Releases
Podcasts
Industry Terms
Guide to Understanding Subrogation
Moving To Self-Funded Health Plan Guide
Referenced-Based Pricing Explained
Hospital Price Transparency Guide
Balance-Billing: What Patients Need To Know
Employee Rights With COVID-19 Vaccines
The No Surprises Act Explained
Mental Health Parity and Addiction Equity Act Explained
Understanding Non-Quantitative Treatment Limitations (NQTLs)
The Insulin Cap Bill Offers Hope for Americans With Diabetes
Phia Group Media
Phia Group Media
A Call for Defensive Legislation
On May 3, 2017 in
Blog
,
ERISA
,
Self Insurance
,
Stop loss
By: Brady Bizarro, Esq.
On April 5th, the House of Representatives passed the Self-Insurance Protection Act (SIPA; H.R. 1304) by a vote of 400 to 16. This was the third iteration of this bill, originally introduced at the suggestion of the Self-Insurance Institute of America (“SIIA”). This legislation is very important for our industry because it blocks federal efforts to regulate small stop-loss plans as health insurance by excluding the plans from the federal definition of “health insurance coverage.” If you were struggling to think of a federal law which redefines stop-loss as health insurance, that is okay. There is no such federal law on the books. Indeed, there has been no legislative proposal at the federal level to redefine stop-loss insurance in this way. This was defensive legislation, designed to ensure that federal regulators do not try to redefine stop-loss insurance. State legislatures around the country should take notice of this approach before it’s too late.
At the state level, we have already seen numerous efforts (often successful) at redefining stop-loss insurance or placing restrictions on coverage. Why are states pushing this kind of legislation? One development that added fuel to the fire was the U.S. Department of Labor’s Technical Release on November 6, 2014. It expressed the opinion that states should not be concerned that stop-loss regulation restricting policies based on attachment points would be preempted by the Employee Retirement Income Security Act (“ERISA”). Since that time, we have seen efforts to restrict stop-loss coverage in California, the District of Columbia, Maryland, New York, New Mexico, Florida, Delaware, Washington, Connecticut, and Utah.
In states where restrictions have not been put in place, or where the restrictions are not severe, employers and insurers alike should be pushing for defensive legislation to reaffirm that stop-loss insurance is not health insurance.
Tagged With:
ERISA
,
Self Insurance