March 2, 2020 -- This is your periodic update of state legislative and regulatory developments affecting companies involved in the self-insurance/captive insurance marketplace. Should you have any questions regarding the information provided in these reports, or would like to alert SIIA of new state legislative and regulatory activity (health care, workers’ compensation and/or captive insurance matters), please contact Adam Brackemyre, Vice President of State Government Relations directly at 202/595-0641, or via e-mail at
Small group stop-loss ban legislation has been reintroduced as
. As of right now, the bill does not have Senate companion legislation and is not scheduled for a hearing in the Assembly. SIIA understands that some legislators and the governor are discussing “small group market” reforms that would likely involve several pieces of legislation.
Last year SIIA spearheaded a lobbying effort that defeated very similar legislation. This year, SIIA will again be meeting with legislators in Trenton and around the state, stressing the need for small employer benefit options and testifying if the bill is held for a hearing.
In Colorado, legislation lowering the state’s stop-loss minimum attachment points has been reintroduced. Assemblywoman Perry Buck’s
would lower minimum attachment points to $10,000 and $15,000 for small group and large group contracts, respectively.
SIIA participated in stakeholder discussions two years ago and the consensus was that current law was fine. SIIA is quietly checking to see if the politics of the issue have changed, but notes that the only bill sponsor is in the minority and not on a committee of jurisdiction. This makes the bill unlikely to move.
Just last week, individual market reinsurance legislation was introduced by Senator Kirk Talbott.
Senate Bill 148
would create a Louisiana Health Reinsurance Association and be funded by health insurance policy and TPA covered lives fees of $2.50 per member per month.
SIIA participated in a coalition that defeated a previous version of this legislation two years ago. SIIA, has been working with the same coalition and plans to attend meetings with legislators in Baton Rouge. Late last year, SIIA submitted
to the Louisiana Department of Insurance opposing a TPA assessment to fund a reinsurance program.
TPAs with a Louisiana license should review this bill carefully, as the legislation may tie Louisiana licensure with Reinsurance Association membership. Another concern is that the legislation requires TPAs, not the clients, to be legally responsible for paying assessments- and subject to penalty for late payments. The commissioner and reinsurance board would have broad regulatory authority, with the board able to conduct audits and “request data” from TPAs and refer TPAs to the commissioner for “sanction” if the TPA is, in the board’s view, non-compliant with a data request.
SIIA will provide regular updates on the progress of this legislation. It should be noted that the association does not oppose all reinsurance programs but strongly opposes taxing self-insured plans to fund them.
The Minnesota Hospital Association and Minnesota Medical Association are supporting legislation that would attempt to require all employers with Minnesota employees to abide by a state law governing independent review organizations (IROs).
SIIA has had a working relationship over the past couple of years with employer groups in that state, has already provided ERISA pre-emption information to allies in Minnesota and will do what is necessary to defeat state laws that prevent uniform administration of health plans.
Senate File 3204/ House File 3398
adds new language “an employer with employees in this state who are covered under a health benefit plan, a health plan company, a preferred provider organization” to a law governing health insurance carrier IRO procedures. The law, as drafted, appears to apply to employers domiciled outside of Minnesota, but who have “employee or employees” in the state. Any health plan or health plan administrator with covered lives in Minnesota should have concerns about the legislation. SIIA believes the ERISA concerns alone may be enough to amend the legislation and address the problems, but will work vigilantly with allies.
The governor has proposed codifying the state’s stop-loss
into law as part of his health care agenda.
SIIA is monitoring the progress of both budget bills that include the stop-loss text,
, and is working with lobbyists in Hartford. If the bills proceed without amendment, there will no effect on current market rules, which is the optimal outcome. SIIA understands that the insurance department and governor only wish to codify the consumer protections into law so that future insurance department staff do not decide to issue bulletins weakening them.
The Maine Joint Health Coverage, Insurance and Financial Services Committee carried over
from last year. The legislation would prohibit small group stop-loss contracts.
SIIA has been active in Maine over the past three years, working closely with the Bureau of Insurance to produce
which enhanced small group stop-loss protections, but allowed small employers reasonable access to self-insurance and stop-loss. SIIA is concerned about closing any market to self-insurance and will see how much the insurance carrier behind this legislation wants to advance it. This legislation has been active for about four years now.
Please also note that a legislative/regulatory update session will be incorporated as part of SIIA’s upcoming Self-Insured Health Plan Executive Forum, scheduled for March 16-18, 2020 in Charleston, SC. Event details can be accessed on-lined at