,i  #aahth ,,congress  #ast ,session    
,h4 ,r4 #bhac  ,,in ,,the ,,house ,,of  
,,representatives  ,april #be1 #bjbc,mr4
 ,good of ,virginia 7for himself and    
,mr4 ,walberg7 introduced the following 
bill2 which was referred to the         
,committee on ,education and the        
,workforce1 and in addition to the      
,committees on ,energy and ,commerce1   
and ,ways and ,means1 for a period to be
 subsequently determined by the         
,speaker1 in each case for consideration
 of such provisions as fall within the  
jurisdiction of the committee concerned 
,a ,,bill  ,to amend the ,employee      
,retirement ,income ,security ,act of   
#aigd1 the ,public ,health ,service     
,act1 and the ,internal ,revenue ,code  
of #aihf to exclude from the definition 
of health insurance coverage certain    
medical stop-loss insurance obtained by 
certain plan sponsors of group health   
plans1 and for other purposes4  #a4     
,short title ,this ,act may be cited as 
the ,self-,insurance ,protection ,act4  

#b4 ,findings ,congress finds the       
following3  7#a7 ,small and large       
employers offer health benefit plan     
coverage to employees in self-funded    
arrangements using company assets or a  
fund1 or by paying premiums to purchase 
fully-insured coverage from a health    
insurance company4  7#b7 ,employers that
 self-fund health benefit plans will    
often purchase stop-loss insurance as a 
financial risk management tool to       
protect against excess or unexpected    
catastrophic health plan claims losses  
that arise above projected costs paid   
out of company assets4  7#c7 ,stop-loss 
coverage insures the employer sponsoring
 the health benefit plan against        
unforeseen health plan claims1 does not 
insure the employee health benefit plan 
itself1 and does not pay health care    
providers for medical services provided 
to the employees4  7#d7                 
,employer-sponsored health benefit plans
 are regulated under the ,employee      
,retirement ,income ,security ,act of   

#aigd1 however1 ,states regulate the    
availability and the coverage terms of  
stop-loss insurance coverage that       
employers purchase to protect company   
assets and to protect a fund against    
excess or unexpected claims losses4     
7#e7 ,both large and small employers    
that choose to self-fund must also be   
able to protect company assets or a fund
 against excess or unexpected claims    
losses and ,states must reasonably      
regulate stop-loss insurance to assure  
its availability to both large and small
 employers4  #c4 ,certain medical       
stop-loss insurance obtained by certain 
plan sponsors of group health plans not 
included under the definition of health 
insurance coverage  7a7 ,,erisa ,section
 #gcc7;b77#a7 of the ,employee          
,retirement ,income ,security ,act of   
#aigd 7#bi ,u4,s4,c4 #aaia;b7b77#a77 is 
amended by adding at the end the        
following sentence3 ,such term shall not
 include a stop-loss policy obtained by 
a self-funded health plan or a plan     

sponsor of a group health plan that     
self-funds the health risks of its plan 
participants to reimburse the plan or   
sponsor for losses that the plan or     
sponsor incurs in providing health or   
medical benefits to such plan           
participants in excess of a             
predetermined level set forth in the    
stop-loss policy obtained by such plan  
or sponsor44  7b7 ,,phsa ,section       
#bgia7;b77#a7 of the ,public ,health    
,service ,act 7#db ,u4,s4,c4            
#cjj;gg-#ia7;b77#a77 is amended by      
adding at the end the following new     
sentence3 ,such term shall not include a
 stop-loss policy obtained by a         
self-funded health plan or a plan       
sponsor of a group health plan that     
self-funds the health risks of its plan 
participants to reimburse the plan or   
sponsor for losses that the plan or     
sponsor incurs in providing health or   
medical benefits to such plan           
participants in excess of a             
predetermined level set forth in the    

stop-loss policy obtained by such plan  
or sponsor44  7c7 ,,irc ,section        
#ihcb7;b77#a77;,a7 of the ,internal     
,revenue ,code of #aihf is amended by   
adding at the end the following new     
sentence3 ,such term shall not include a
 stop-loss policy obtained by a         
self-funded health plan or a plan       
sponsor of a group health plan that     
self-funds the health risks of its plan 
participants to reimburse the plan or   
sponsor for losses that the plan or     
sponsor incurs in providing health or   
medical benefits to such plan           
participants in excess of a             
predetermined level set forth in the    
stop-loss policy obtained by such plan  
or sponsor44  #d4 ,effect on other laws 
,section #ead7;b7 of the ,employee      
,retirement ,income ,security ,act of   
#aigd 7#bi ,u4,s4,c4 #aadd7;b77 is      
amended by adding at the end the        
following3  7#aj7 ,the provisions of    
this title 7including part #g relating  
to group health plans7 shall preempt    

,state laws insofar as they may now or  
hereafter prevent an employee benefit   
plan that is a group health plan from   
insuring against the risk of excess or  
unexpected health plan claims losses4  4