(6) "SMALL EMPLOYER" HAS THE MEANING STATED IN § 15-1201(M) OF
THIS TITLE.
(7) (5) "SPECIFIC ATTACHMENT POINT" MEANS THE DOLLAR AMOUNT
FOR A IN LOSSES ATTRIBUTABLE TO A SINGLE INDIVIDUAL BENEFICIARY SINGLE
LOSS IN A POLICY YEAR ABOVE BEYOND WHICH THE STOP-LOSS INSURER ASSUMES
ALL OR PART OF THE LIABILITY FOR BENEFITS PAYABLE LOSSES INCURRED BY THE
HEALTH PLAN INSURED.
(8) (6) "STOP-LOSS INSURANCE" MEANS INSURANCE PROVIDED TO AN
EMPLOYER, OR TRUSTEE OR ASSOCIATION ON BEHALF OF AN EMPLOYER, AGAINST
LIABILITY FOR BENEFITS PAYABLE BY A HEALTH PLAN THAT IS PURCHASED BY A
PERSON, OTHER THAN A HEALTH CARE PROVIDER, TO PROTECT THE PERSON
AGAINST CATASTROPHIC, EXCESS, OR UNEXPECTED LOSSES SUSTAINED BY THE
PERSON.
(B) THIS SECTION APPLIES TO EACH STOP-LOSS INSURANCE POLICY OR
CONTRACT THAT IS DELIVERED OR ISSUED FOR DELIVERY IN THE STATE TO A SMALL
EMPLOYER.
(C) AN INSURER MAY NOT ISSUE, DELIVER OR OFFER A POLICY OR CONTRACT
SUBJECT TO THIS SECTION MAY NOT HAVE OF STOP-LOSS INSURANCE, IF THE
POLICY HAS:
(1) A SPECIFIC ATTACHMENT POINT OF LESS THAN $10,000; OR
(2) AN AGGREGATE ATTACHMENT POINT OF LESS THAN 115% OF
EXPECTED CLAIMS.
(D) AN INSURER WHO OFFERS OR ISSUES A STOP-LOSS INSURANCE POLICY
THAT DOES NOT MEET THE REQUIREMENTS OF THIS SECTION SHALL BE SUBJECT TO
THE SANCTIONS SET FORTH IN § 4-113 OF THIS ARTICLE FOR AUTHORIZED INSURERS
AND § 4-212 OF THIS ARTICLE FOR UNAUTHORIZED INSURERS.
(E) NOTHING IN THIS SECTION SHALL BE CONSTRUED AS:
(1) IMPOSING ANY REQUIREMENT OR DUTY ON ANY PERSON OTHER
THAN AN INSURER; OR
(2) TREATING ANY STOP-LOSS POLICY AS A DIRECT POLICY OF HEALTH
INSURANCE.
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect
June 1, 1999.
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