Us Congress 2025-2026 Regular Session

Us Congress House Bill HB2571 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	I
2	2	119THCONGRESS
3	3	1
4	4	STSESSION H. R. 2571
5	5	To amend the Employee Retirement Income Security Act of 1974 to exclude
6	6	from the definition of health insurance coverage certain medical stop-
7	7	loss insurance obtained by certain plan sponsors of group health plans,
8	8	and for other purposes.
9	9	IN THE HOUSE OF REPRESENTATIVES
10	10	APRIL1, 2025
11	11	Mr. O
12	12	NDERintroduced the following bill; which was referred to the Committee
13	13	on Education and Workforce
14	14	A BILL
15	15	To amend the Employee Retirement Income Security Act
16	16	of 1974 to exclude from the definition of health insur-
17	17	ance coverage certain medical stop-loss insurance ob-
18	18	tained by certain plan sponsors of group health plans,
19	19	and for other purposes.
20	20	Be it enacted by the Senate and House of Representa-1
21	21	tives of the United States of America in Congress assembled, 2
22	22	SECTION 1. SHORT TITLE. 3
23	23	This Act may be cited as the ‘‘Self-Insurance Protec-4
24	24	tion Act’’. 5
25	25	SEC. 2. FINDINGS. 6
26	26	Congress finds the following: 7
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29	29	•HR 2571 IH
30	30	(1) Small and large employers offer health ben-1
31	31	efit plan coverage to employees in self-funded ar-2
32	32	rangements using company assets or a fund, or by 3
33	33	paying premiums to purchase fully-insured coverage 4
34	34	from a health insurance company. 5
35	35	(2) Employers that self-fund health benefit 6
36	36	plans will often purchase stop-loss insurance as a fi-7
37	37	nancial risk management tool to protect against ex-8
38	38	cess or unexpected catastrophic health plan claims 9
39	39	losses that arise above projected costs paid out of 10
40	40	company assets. 11
41	41	(3) Stop-loss coverage insures the employer 12
42	42	sponsoring the health benefit plan against unfore-13
43	43	seen health plan claims, does not insure the em-14
44	44	ployee health benefit plan itself, and does not pay 15
45	45	health care providers for medical services provided to 16
46	46	the employees. 17
47	47	(4) Employer-sponsored health benefit plans are 18
48	48	regulated under the Employee Retirement Income 19
49	49	Security Act of 1974, however, States regulate the 20
50	50	availability and the coverage terms of stop-loss in-21
51	51	surance coverage that employers purchase to protect 22
52	52	company assets and to protect a fund against excess 23
53	53	or unexpected claims losses. 24
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56	56	•HR 2571 IH
57	57	(5) Both large and small employers that choose 1
58	58	to self-fund must also be able to protect company as-2
59	59	sets or a fund against excess or unexpected claims 3
60	60	losses and States must reasonably regulate stop-loss 4
61	61	insurance to assure its availability to both large and 5
62	62	small employers. 6
63	63	SEC. 3. CERTAIN MEDICAL STOP-LOSS INSURANCE OB-7
64	64	TAINED BY CERTAIN PLAN SPONSORS OF 8
65	65	GROUP HEALTH PLANS NOT INCLUDED 9
66	66	UNDER THE DEFINITION OF HEALTH INSUR-10
67	67	ANCE COVERAGE. 11
68	68	Section 733(b)(1) of the Employee Retirement In-12
69	69	come Security Act of 1974 (29 U.S.C. 1191b(b)(1)) is 13
70	70	amended by adding at the end the following sentence: 14
71	71	‘‘Such term shall not include a stop-loss policy obtained 15
72	72	by a self-insured group health plan or a plan sponsor of 16
73	73	a group health plan that self-insures the health risks of 17
74	74	its plan participants to reimburse the plan or sponsor for 18
75	75	losses that the plan or sponsor incurs in providing health 19
76	76	or medical benefits to such plan participants in excess of 20
77	77	a predetermined level set forth in the stop-loss policy ob-21
78	78	tained by such plan or sponsor.’’. 22
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81	81	•HR 2571 IH
82	82	SEC. 4. EFFECT ON OTHER LAWS. 1
83	83	Section 514(b) of the Employee Retirement Income 2
84	84	Security Act of 1974 (29 U.S.C. 1144(b)) is amended by 3
85	85	adding at the end the following: 4
86	86	‘‘(10) The provisions of this title (including part 7 5
87	87	relating to group health plans) shall preempt State laws 6
88	88	insofar as they may now or hereafter prevent an employee 7
89	89	benefit plan that is a group health plan from insuring 8
90	90	against the risk of excess or unexpected health plan claims 9
91	91	losses.’’. 10
92	92	Æ
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