Section 23-62-111 - Employee benefit stop-loss insurance

(a) As used in this subchapter, 'employee benefit stop-loss insurance' means coverage that insures an employer or an employer-sponsored health plan against the risk that: (1) One (1) claim will exceed a specific dollar amount; or(2) The entire loss of a self-insurance plan will exceed a specific dollar amount.(b) An insurer authorized to transact accident and health insurance business in this state may issue employee benefit stop-loss insurance in this state.(c) An insurer shall not issue an employee benefit stop-loss insurance policy that:(1) Has an annual attachment point for claims incurred per individual that is less than twenty thousand dollars ($20,000);(2) Has an annual aggregate attachment point for groups of fifty (50) or less that is lower than one hundred twenty percent (120%) of expected claims;(3) Has an annual aggregate attachment point for groups of fifty-one (51) or more that is lower than one hundred ten percent (110%) of expected claims; or(4) Provides for direct coverage of healthcare expenses of an individual.(d) The Insurance Commissioner may adopt rules that carry out the requirements of this section, including without limitation rules that require:(1)

ct coverage of healthcare expenses of an individual.(d) The Insurance Commissioner may adopt rules that carry out the requirements of this section, including without limitation rules that require:(1) Additional standards for employee benefit stop-loss insurance policies; and(2) Disclosures to policyholders by an insurance carrier providing employee benefit stop-loss insurance.Amended by Act 2021, No. 383,§ 1, eff. 7/28/2021.Acts 2007, No. 496, § 4; 2009, No. 726, § 10; 2011, No. 760, § 2.