I 

115TH CONGRESS 

1ST SESSION H. R. 1304 

To amend the Employee Retirement Income Security Act of 1974, the Public 

Health Service Act, 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 

MARCH 2, 2017 

Mr. ROE of Tennessee (for himself and Mr. WALBERG) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, and Education and the Workforce, 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 Employee Retirement Income Security Act 

of 1974, the Public Health Service Act, 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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•HR 1304 IH

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) ERISA.—Section 733(b)(1) of the Employee Re10 tirement Income Security Act of 1974 (29 U.S.C. 

11 1191b(b)(1)) is amended by adding at the end the fol12 lowing new sentence: ‘‘Such term shall not include a stop13 loss policy obtained by a self-insured health plan or a plan 

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

15 risks of its plan participants to reimburse the plan or 

16 sponsor for losses that the plan or sponsor incurs in pro17 viding health or medical benefits to such plan participants 

18 in excess of a predetermined level set forth in the stop19 loss policy obtained by such plan or sponsor.’’. 

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

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

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

23 shall not include a stop-loss policy obtained by a self-in24 sured health plan or a plan sponsor of a group health plan 

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

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


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•HR 1304 IH

1 or sponsor incurs in providing health or medical benefits 

2 to such plan participants in excess of a predetermined level 

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

4 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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