Section 31-3821 - DefinitionsFor the purposes of this chapter, the term:
(1) "Aggregate attachment point" means the total amount of health claims incurred by a small employer in a policy year for all covered employees and their dependents, and covered by a stop-loss insurance policy, above which the stop-loss insurer incurs a liability for payment under aggregate stop-loss coverage.(2) "Attachment point" means the claims amount incurred by an insured group beyond which the insurer incurs a liability for payment.(3) "Commissioner" means the Commissioner of the Department of Insurance, Securities and Banking.(4) "Expected claims" means the total amount of claims that, in the absence of medical stop-loss insurance, are projected to be incurred by the insured using reasonable and accepted actuarial principles in a policy year.(5) "Individual attachment point" means the amount of health claims incurred by a small employer in a policy year for an individual employee or dependent of an employee, and covered by a stop-loss insurance policy, above which the stop-loss insurer incurs a liability for payment, under individual stop-loss coverage.(6) "Stop-loss insurance" means coverage that insures an employer or an employer-sponsored health plan against the risk that: (A) One claim will exceed a specific dollar amount; or(B) The entire loss of a self-insurance plan will exceed a specific dollar amount.May 2, 2015, D.C. Law 20-265, § 201, 62 DCR 1529.