La. Admin. Code tit. 37 § XIII-16917
Current through Register Vol. 50, No. 6, June 20, 2024
Section XIII-16917 - Additional Requirements for Stop-Loss or Excess InsuranceA. Stop loss or excess insurance issued to a self-insurance plan must meet the following requirements. 1. The plan must include a provision stating that aggregate stop-loss or excess coverage and specific stop-loss or excess coverage may only be provided by an insurer licensed to do business in the state of Louisiana.2. The stop-loss or excess policies must contain provisions to cover incurred, unpaid claims liability in the event of plan termination.3. The stop-loss or excess insurer shall bear the risk of coverage for any employer participating in the self-insurance plan that becomes insolvent with outstanding contributions due.4. The stop-loss or excess insurer shall provide coverage with rates not subject to adjustment by the stop-loss or excess insurer during the first 12 months of coverage, unless: a. there is a change in the benefits provided under the group health plan; and/orb. enrollment under the group health plan changes by at least 10 percent.5. A stop loss or excess insurer must submit its proposed stop-loss or excess policy to the Commissioner of the Department of Insurance for review at least 30 days prior to the proposed self-insurance plan's effective date and at least 30 days prior to any subsequent renewal date.La. Admin. Code tit. 37, § XIII-16917
Promulgated by the Department of Insurance, Office of the Commissioner, LR 46699 (5/1/2020).AUTHORITY NOTE: Promulgated by the Department of Insurance, Office of the Commissioner, in accordance with R.S. 22:2 and 22:883.