North Carolina 2025-2026 Regular Session

North Carolina House Bill H156 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1	1		GENERAL ASSEMBLY OF NORTH CAROLINA
2	2		SESSION 2025
3		-	H 1
4		-	HOUSE BILL 156
	3	+	H D
	4	+	HOUSE BILL DRH30049-MR-50
	5	+
5	6
6	7
7	8		Short Title: Increase Access for Small Employers/Insurance. (Public)
8		-	Sponsors: Representatives Paré, White, Humphrey, and Tyson (Primary Sponsors).
9		-	For a complete list of sponsors, refer to the North Carolina General Assembly web site.
10		-	Referred to: Insurance, if favorable, Health, if favorable, Judiciary 1, if favorable, Rules,
11		-	Calendar, and Operations of the House
12		-	February 21, 2025
13		-	H156 -v-1
	9	+	Sponsors: Representative Paré.
	10	+	Referred to:
	11	+
	12	+	DRH30049 -MR-50
14	13		A BILL TO BE ENTITLED 1
15	14		AN ACT INCREASING SMALL EMPLOYER ACCESS TO STOP LOSS, CATASTROPHIC, 2
16	15		AND REINSURANCE COVERAGE. 3
17	16		The General Assembly of North Carolina enacts: 4
18	17		SECTION 1. G.S. 58-50-130(a)(5) reads as rewritten: 5
19	18		"(5) No small employer carrier, insurer, subsidiary of an insurer, or controlled 6
20	19		individual of an insurance holding company shall provide stop loss, 7
21	20		catastrophic, or reinsurance coverage to small employers who employ fewer 8
22	21		than 12 five eligible employees that does not comply with the underwriting, 9
23	22		rating, and other applicable standards in this Act. An insurer shall not issue a 10
24	23		stop loss health insurance policy to any person, firm, corporation, partnership, 11
25	24		or association defined as a small employer that does any of the following: 12
26	25		a. Provides direct coverage of health expenses payable to an individual. 13
27	26		b. Has an annual attachment point for claims incurred per individual that 14
28	27		is lower than twenty thousand dollars ($20,000) for plan years 15
29	28		beginning in 2013. For subsequent policy years, the amount shall be 16
30	29		indexed using the Consumer Price Index for Medical Services for All 17
31	30		Urban Consumers for the South Region and shall be rounded to the 18
32	31		nearest whole thousand dollars. The index factor shall be the index as 19
33	32		of July of the year preceding the change divided by the index as of July 20
34	33		2012. 21
35	34		c. Has an annual aggregate attachment point lower than the greater of 22
36	35		one of the following: 23
37	36		1. One hundred twenty percent (120%) of expected claims. 24
38	37		2. Twenty thousand dollars ($20,000) for plan years beginning in 25
39	38		2013. For subsequent policy years, the amount shall be indexed 26
40	39		using the Consumer Price Index for Medical Services for All 27
41	40		Urban Consumers for the South Region and shall be rounded 28
42	41		to the nearest whole thousand dollars. The index factor shall be 29
43	42		the index as of July of the year preceding the change divided 30
44	43		by the index as of July 2012. 31
45	44		Nothing in this subsection prohibits an insurer from providing additional 32
46	45		incentives to small employers with benefits promoting a medical home or 33
47		-	benefits that provide health care screenings, are focused on outcomes and key 34 General Assembly Of North Carolina Session 2025
48		-	Page 2 House Bill 156-First Edition
49		-	performance indicators, or are reimbursed on an outcomes basis rather than a 1
50		-	fee-for-service basis." 2
51		-	SECTION 2. This act becomes effective October 1, 2025, and applies to contracts 3
52		-	issued, renewed, or amended on or after that date. 4
	46	+	benefits that provide health care screenings, are focused on outcomes and key 34
	47	+	performance indicators, or are reimbursed on an outcomes basis rather than a 35
	48	+	fee-for-service basis." 36
	49	+	H.B. 156
	50	+	Feb 18, 2025
	51	+	HOUSE PRINCIPAL CLERK General Assembly Of North Carolina Session 2025
	52	+	Page 2 DRH30049-MR-50
	53	+	SECTION 2. This act becomes effective October 1, 2025, and applies to contracts 1
	54	+	issued, renewed, or amended on or after that date. 2