Close Close
Sign In
Newsletters
Popular Financial Topics Discover relevant content from across the suite of ALM legal publications From the Industry More content from ThinkAdvisor and select sponsors Investment Advisor Issue Gallery Read digital editions of Investment Advisor Magazine Tax Facts Get clear, current, and reliable answers to pressing tax questions
Luminaries Awards
Podcast Center Video Center Webcasts Resource Center Events
About ThinkAdvisor Contact Us Advertise With Us Asset & Logo Licensing Sitemap Terms of Service Privacy Policy Copyright © 2024 ALM Global, LLC. All Rights Reserved.
ThinkAdvisor

Financial Planning > Tax Planning > Tax Loss Harvesting

Stop-loss draft authors want paid claims data

By Allison Bell

X
Your article was successfully shared with the contacts you provided.

The state regulators who are working on a white paper about stop-loss insurance wish they had more information about stop-loss claim payments.

The regulators talk about their hunger for stop-loss claims data in a new draft of the paper.

The Employee Retirement Income Security Act (ERISA) Working Group, part of the National Association of Insurance Commissioners (NAIC), is developing the paper because of concerns that the NAIC’s current stop-loss models may be outmoded, and that small businesses may use very small stop-loss arrangements to evade Patient Protection and Affordable Care Act (PPACA) small-group coverage requirements.

See also: The new PPACA stop-loss guidance: What agents should know.

PPACA applies some coverage requirements to self-insured plans but exempts the plans from others.

In the new draft, the drafters note at one point that owners of small businesses may not know much about stop-loss insurance and may need extra help with understanding how stop-loss plans can differ from ordinary small-group health insurance policies.

Later in the draft, the drafters say they would like to see states collect data on the stop-loss market. 

“Basic data collection on premiums and claims paid, possibly in categories related to group size, could provide states with valuable information about the market,” the drafters say.

They note that Colorado collects information about premiums, broken down by group size, but no information about claims paid, and that Missouri collects information both about premiums and claims, but not broken down by group size.

The drafters suggest that Congress could deal with concerns about stop-loss-related antiselection by requiring stop-loss providers to sell small stop-loss plans on a guaranteed-issue basis, just as they require insurers to sell fully insured small-group coverage on a guaranteed-issue basis.

See also: Stop-loss draft warns of coverage twists

NOT FOR REPRINT

© 2024 ALM Global, LLC, All Rights Reserved. Request academic re-use from www.copyright.com. All other uses, submit a request to [email protected]. For more information visit Asset & Logo Licensing.