Phia Group Media


Phia Group Media

SIIA State Legislative/Regulatory Update Report

March 16, 2015 — 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 202/595-0641, or via e-mail at

Maryland- Stop Loss Bill Amendments Proposed

In the face of stiff opposition by SIIA and allied stakeholders, the principal backers of HB 552/SB 703 proposed significant changes to the legislation, including lower attachment points and a study of several issues.

The drafted amendments would decrease the proposed minimum individual attachment point to $22,500 and minimum aggregate attachment point to 120 percent. In addition, Maryland would establish a study committee to review various issues relating to the stop loss and the Affordable Care Act (ACA) including how many businesses would be affected by the ACA’s “small group” definition change and how other states regulate stop loss insurance. The study would require two reports, one due in 2015 and a second due in 2016.

SIIA and its allies have received the proposed amendments and are discussing a unified response.

Contact SIIA’s Director of State Government Relations, Adam Brackemyre at if you have additional questions.

New Mexico- Stop Loss Bulletin Rescinded
Last Tuesday, the New Mexico Department of Insurance rescinded Bulletin 2015-005 by issuing Bulletin 2015-010. As previously reported, Bulletin 2015-005 required all new and renewing stop loss contracts to meet the ACA health insurance standards and, according to SIIA members, had frozen the stop loss market and created chaos in the insurance market.

Sources in Santa Fe report that the department of insurance heard opposition from numerous angles, both public and private. Legislators heard significant opposition from constituents and expressed concern to the department. One influential insurance committee legislator had multiple conversations with the superintendent, as did a former insurance superintendent. Major employers, including a major public university that has a self-insured health plan with stop loss, also faced the loss of their current insurance plan and expressed opposition.

The newest insurance bulletin will establish a study committee for the issue and SIIA will watch for its formation and any opportunity to engage.

New York State- Albany Day on the Hill
Last week, SIIA hosted a successful lobby day, which included participation by about 20 representatives of association members and other allied stakeholders.

Individuals representing the following companies participated:
Diversified Group
ELMC Group
H.H.C. Group
Leading Edge Administrators
UltraBenefits, Inc.

At breakfast, Senator James Seward, the sponsor of S.2366 said that the legislation will be heard in his committee very soon. In reviewing the Senate Insurance Committee’s schedule, S.2366 is on the calendar for today.

Assembly Insurance Chair Kevin Cahill’s breakfast comments were more vague and nuanced, reflecting the reality that the chairman must consult with many Assembly stakeholders to advance legislation in that body. SIIA already knew this and scheduled 21 targeted meetings, primarily with Assembly Democrats, to garner support for Chairman Cahill’s legislation, A.1154.

Departing to the capitol, SIIA members split into three teams to cover meetings with nearly all Assembly Democrats on the Insurance Committee, Assembly and Senate leadership and the New York State exchange. In general, meetings went very well. Most Assembly Members were supportive and some even promised to co-sponsor the legislation. SIIA’s lobbyist will be following up with co-sponsorship requests and with offices where SIIA members met with staff members.

From all indications, this was a very productive day and we took necessary steps to advance the legislation in the New York State Assembly. SIIA will carefully assess the next steps we need to take, which may include another round of meetings in Albany. At this time, the need for another large Lobby Day is unlikely.

To SIIA’s knowledge, only one regional insurance carrier has expressed opposition to A.1154/S.2366 and it was apparent in meetings with Assembly Insurance Committee members that SIIA was the only group to have brought A.1154 and the stop loss ban to the legislator’s or staff’s attention.

Again, a big “thank you” to everyone who attended the day in Albany and to the many others who either facilitated a colleague’s attendance or whose schedule changed at the last minute and precluded his or her attendance.

Florida- Stop-Loss Legislation Update
Legislation moving through a House committee has some odd language that may preclude lasering.

SIIA has been monitoring the progress of House Bill 731, which at first appeared to codify Florida regulation requiring a $20,000 minimum individual attachment point and other elements of the NAIC Model Stop Loss Act. However, the substitute bill added this language “A stop-loss insurance policy authorized under this section must cover 100 percent of all claims equal to or above the attachment point…”

SIIA does not believe the intent of the bill sponsor is to preclude lasering and will work with members and allies to address this.

Utah- Technical Corrections Legislation Affecting Stop Loss Advances
Utah House Bill (HB) 24 is swiftly moving toward passage.

As previously reported, HB 24 contains Department of Insurance (DOI)-supported language, developed in part by conversation that DOI staff had with SIIA members, deleting a mandatory stop loss universal application and clarifying stop loss carrier liability if a plan sponsor terminates.

SIIA expects this legislation will be sent to the Governor’s office soon