Filed Under:Health Insurance, Individual Health

Consumer Rep Sees Industry Divided on Stop-Loss

Timothy Jost

The people who help small employers set up and run small self-funded health plans have been lobbying to keep the current stop-loss insurance guidelines in place.

Some have suggested that employers with as few as 20 employees may now choose to try to escape from PPACA benefits rules by self-insuring.Critics say that the healthiest small employers will be more likely to self-insure, and that the flight of the best risks to the self-insured market could lead to escalating claims costs and premium increases in the insured small group market.

NAIC working groups are  talking about the idea of increasing the minimum per-employee or whole-plan small group stop-loss deductibles. Christina Goe, a Minnesota regulator, has suggested that the NAIC ought to consider revising the stop-loss minimums primarily because they were set long ago and now appear to be out of sync with the health insurance market.

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