A BILL TO BE ENTITLED AN ACT TO MAKE TECHNICAL CHANGES TO THE SMALL EMPLOYER GROUP HEALTH COVERAGE REFORM ACT TO MITIGATE THE EFFECTS OF THE FEDERAL AFFORDABLE CARE ACT ON NORTH CAROLINA'S SMALL BUSINESSES AND TO INCREASE STOP LOSS INSURANCE OPTIONS FOR SMALL EMPLOYERS.
Senate committee substitute makes the following changes to the 4th edition.
Changes the long title.
Amends GS 58-50-1230(a), regarding stop loss health insurance, providing that an insurer will not issue a stop loss health insurance policy to any entity defined as a small employer if they do any of the following:
(1) Provide direct coverage of health expenses payable to an individual.
(2) Have an annual attachment point for claims incurred per individual that is lower than $20,000.
(3) Have an annual aggregate attachment point lower than the greater of 120% of expected claims or $20,000.
Deletes language that prohibited a specified insurance holding company from acting as an administrator or claims paying agent, as opposed to an insurer, on behalf of small groups.
Above provisions are effective October 1, 2013, and apply to all stop loss insurance contracts and policies issued, renewed, or amended on or after that date.
Directs the Department of Insurance to adopt rules providing for the oversight, monitoring of, and reporting by insurers and third party administrators who administer health benefit plans with stop loss coverage pursuant to this act.
© 2021 School of Government The University of North Carolina at Chapel Hill
This work is copyrighted and subject to "fair use" as permitted by federal copyright law. No portion of this publication may be reproduced or transmitted in any form or by any means without the express written permission of the publisher. Distribution by third parties is prohibited. Prohibited distribution includes, but is not limited to, posting, e-mailing, faxing, archiving in a public database, installing on intranets or servers, and redistributing via a computer network or in printed form. Unauthorized use or reproduction may result in legal action against the unauthorized user.