SB 1431 Summary

• Requires stop-loss insurers to offer coverage to all employees and dependents of small employers and prohibits exclusions based on health status-related factors.

• Mandates stop-loss insurers renew policies at the small employer's option, with limited exceptions for nonpayment, fraud, financial impairment, or market exit with 180-day notice.

• Prohibits stop-loss policies issued on or after January 1, 2012, from containing individual attachment points below $45,000 or aggregate attachment points below the greater of $15,000 per covered person, 130% of expected claims, or $60,000.

• Prohibits direct coverage provisions in stop-loss policies that would make insurers directly liable to employees for health claims.

• Subjects violating insurers to administrative penalties with fines deposited in the General Fund; exempts policies issued before January 1, 2012, and certain multiple employer welfare arrangements.