PPACA: sun shines on stop-loss market

By National Underwriter

National Underwriter


By Allison Bell

Players in the small group health stop-loss insurance market have different ideas about what typical stop-loss attachment points really are.

Lee Johnson, president of Mid-America Benefits Inc., Omaha, Neb., says a typical client employer with 50 to 100 employees as a specific, or per-employee, attachment of about $20,000 to $40,000.

Steve Gauldin, a vice president at TRISTAR Benefit Administrators, West Des Moines, Iowa, says he thinks specific attachment points at a typical employer with 25 to 100 employees might range from $25,000 to $35,000.

Blue Cross Blue Shield of Kansas, Topeka, Kan., says the stop-loss options available for employers with fewer than 100 employees at his company have specific attachment points ranging from $10,000 -- the state minimum -- up to $75,000.

Sandy Praeger, the Kansas insurance commissioner and chair of the Health Insurance and Managed Care Committee at the National Association of Insurance Commissioners (NAIC), Kansas City, Mo., writes in a letter sent on behalf of the NAIC that states that express minimum attachment points in terms of dollar figures include Colorado, with a minimum of $15,000; Kansas, Maryland, North Dakota and Oregon, which each impose a minimum of $10,000; and Maine, which imposes a minimum of $20,000.

The Employee Benefits Security Administration (EBSA), an arm of the U.S. Labor Department, has posted the comment letters that provide those figures in a collection of 108 responses to an EBSA request for information (RFI) on stop-loss information that was released this past spring.

Employers that self-insure group health benefits use stop-loss programs to limit their risk.

EBSA put out the RFI after receiving suggestions that some small employers might use stop-loss programs to avoid having to complay with the Patient Protection and Affordable Care Act of 2010 (PPACA).

PPACA exempts self-insured plans from having to meet many PPACA requirements.

Originally published on LifeHealthPro.com