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.
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.