Louisiana Administrative Code
Title 37 - INSURANCE Part
Part XIII - Regulations
Chapter 169 - Regulation 116-Stop-Loss or Excess Policies of Insurance
Section XIII-16917 - Additional Requirements for Stop-Loss or Excess Insurance
Universal Citation: LA Admin Code XIII-16917
Current through Register Vol. 50, No. 9, September 20, 2024
A. 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/or
b. 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.
AUTHORITY NOTE: Promulgated by the Department of Insurance, Office of the Commissioner, in accordance with R.S. 22:2 and 22:883.
Disclaimer: These regulations may not be the most recent version. Louisiana may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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