Section 31A-43-301 - Stop-loss insurance coverage standards(1) A small employer stop-loss insurance contract shall: (a) be issued to the small employer to provide insurance to the group health benefit plan, not the employees of the small employer;(b) have a contract term with guaranteed rates for at least 12 months, without adjustment, unless there is a change in the benefits provided under the small employer's health plan during the contract period;(c) include both a specific attachment point and an aggregate attachment point in a contract;(d) align stop-loss plan benefit limitations and exclusions with a small employer's health plan benefit limitations and exclusions, including any annual or lifetime limits in the employer's health plan;(e) have an annual specific attachment point that is at least $10,000;(f) have an annual aggregate attachment point that may not be less than 85% of expected claims;(g) pay stop-loss claims: (i) incurred during the contract period; and(ii) paid within 12 months after the expiration date of the contract; and(h) include provisions to cover incurred and unpaid stop-loss claims when the small employer's stop-loss plan terminates.(2) A small employer stop-loss contract shall not:(a) include lasering; and(b) pay claims directly to an individual employee, member, or participant.Amended by Chapter 244, 2015 General Session ,§ 53, eff. 5/12/2015.Amended by Chapter 300, 2014 General Session ,§ 64, eff. 5/13/2014.Amended by Chapter 290, 2014 General Session ,§ 64, eff. 5/13/2014.Added by Chapter 341, 2013 General Session ,§ 34, eff. 4/1/2013.