I 

113TH CONGRESS 

1ST SESSION H. R. 3462 

To amend the Public Health Service Act, the Employee Retirement Income 

Security Act of 1974, and the Internal Revenue Code of 1986 to exclude 

from the definition of health insurance coverage certain medical stoploss insurance obtained by certain plan sponsors of group health plans. 

IN THE HOUSE OF REPRESENTATIVES 

NOVEMBER 13, 2013 

Mr. CASSIDY (for himself and Mr. ROE of Tennessee) introduced the following 

bill; which was referred to the Committee on Energy and Commerce, and 

in addition to the Committees on Education and the Workforce and Ways 

and Means, for a period to be subsequently determined by the Speaker, 

in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned 

A BILL 

To amend the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal 

Revenue Code of 1986 to exclude from the definition 

of health insurance coverage certain medical stop-loss 

insurance obtained by certain plan sponsors of group 

health plans. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Self-Insurance Protec3 tion Act’’. 

4 SEC. 2. CERTAIN MEDICAL STOP-LOSS INSURANCE OB5 TAINED BY CERTAIN PLAN SPONSORS OF 

6 GROUP HEALTH PLANS NOT INCLUDED 

7 UNDER THE DEFINITION OF HEALTH INSUR8 ANCE COVERAGE. 

9 (a) PHSA.—Section 2791(b)(1) of the Public Health 

10 Service Act (42 U.S.C. 300gg–91(b)(1)) is amended by 

11 adding at the end the following new sentence: ‘‘Such term 

12 shall not include a stop loss policy obtained by a self-in13 sured health plan or a plan sponsor of a group health plan 

14 that self-insures the health risks of its plan participants 

15 to reimburse the plan or sponsor for losses that the plan 

16 or sponsor incurs in providing health or medical benefits 

17 to such plan participants in excess of a predetermined level 

18 set forth in the stop loss policy obtained by such plan or 

19 sponsor.’’. 

20 (b) ERISA.—Section 733(b)(1) of the Employee Re21 tirement Income Security Act of 1974 (29 U.S.C. 

22 1191b(b)(1)) is amended by adding at the end the fol23 lowing new sentence: ‘‘Such term shall not include a stop 

24 loss policy obtained by a self-insured health plan or a plan 

25 sponsor of a group health plan that self-insures the health 

26 risks of its plan participants to reimburse the plan or 

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1 sponsor for losses that the plan or sponsor incurs in pro2 viding health or medical benefits to such plan participants 

3 in excess of a predetermined level set forth in the stop 

4 loss policy obtained by such plan or sponsor.’’. 

5 (c) IRC.—Section 9832(b)(1)(A) of the Internal Rev6 enue Code of 1986 is amended by adding at the end the 

7 following new sentence: ‘‘Such term shall not include a 

8 stop loss policy obtained by a self-insured health plan or 

9 a plan sponsor of a group health plan that self-insures 

10 the health risks of its plan participants to reimburse the 

11 plan or sponsor for losses that the plan or sponsor incurs 

12 in providing health or medical benefits to such plan par13 ticipants in excess of a predetermined level set forth in 

14 the stop loss policy obtained by such plan or sponsor.’’. 

Æ 

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