NC S297

Reduces the employee threshold for small employers from 20 to 5 eligible employees for purposes of stop loss, catastrophic, and reinsurance coverage eligibility

Maintains minimum annual attachment point of $20,000 per individual claim (indexed annually using Consumer Price Index for Medical Services, South Region)

Maintains minimum annual aggregate attachment point at the greater of 120% of expected claims or $20,000 (indexed annually using same Consumer Price Index methodology)

Permits insurers to provide additional incentives to small employers with benefits promoting medical homes, health care screenings, outcomes-based performance, or reimbursed on outcomes basis rather than fee-for-service

Becomes effective October 1, 2023, and applies to contracts issued, renewed, or amended on or after that date