IB 

115TH CONGRESS 

1ST SESSION H. R. 1304 

[Report No. 115–53, Part I] 

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 

MARCH 20, 2017 

Additional sponsors: Mr. MITCHELL, Ms. STEFANIK, Mr. SESSIONS, Mr. 

FLORES, and Mr. MESSER

MARCH 20, 2017 

Reported from the Committee on Education and the Workforce with an 

amendment and ordered to be printed 

[Strike out all after the enacting clause and insert the part printed in italic] 

[For text of introduced bill, see copy of bill as introduced on March 2, 2017] 


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•HR 1304 RH

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. 


sradovich on DSK3GMQ082PROD with BILLS
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•HR 1304 RH

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

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Self-Insurance Protec5 tion Act’’. 

6 SEC. 2. CERTAIN MEDICAL STOP-LOSS INSURANCE OB7 TAINED BY CERTAIN PLAN SPONSORS OF 

8 GROUP HEALTH PLANS NOT INCLUDED 

9 UNDER THE DEFINITION OF HEALTH INSUR10 ANCE COVERAGE. 

11 (a) ERISA.—Section 733(b)(1) of the Employee Re12 tirement Income Security Act of 1974 (29 U.S.C. 

13 1191b(b)(1)) is amended by adding at the end the following 

14 sentence: ‘‘Such term shall not include a stop-loss policy 

15 obtained by a self-insured health plan or a plan sponsor 

16 of a group health plan that self-insures the health risks of 

17 its plan participants to reimburse the plan or sponsor for 

18 losses that the plan or sponsor incurs in providing health 

19 or medical benefits to such plan participants in excess of 

20 a predetermined level set forth in the stop-loss policy ob21 tained by such plan or sponsor.’’. 

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

23 Service Act (42 U.S.C. 300gg–91(b)(1)) is amended by add24 ing at the end the following new sentence: ‘‘Such term shall 

25 not include a stop-loss policy obtained by a self-insured 


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•HR 1304 RH

1 health plan or a plan sponsor of a group health plan that 

2 self-insures the health risks of its plan participants to reim3 burse the plan or sponsor for losses that the plan or sponsor 

4 incurs in providing health or medical benefits to such plan 

5 participants in excess of a predetermined level set forth in 

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

7 (c) IRC.—Section 9832(b)(1)(A) of the Internal Rev8 enue Code of 1986 is amended by adding at the end the 

9 following new sentence: ‘‘Such term shall not include a stop10 loss policy obtained by a self-insured health plan or a plan 

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

12 risks of its plan participants to reimburse the plan or spon13 sor for losses that the plan or sponsor incurs in providing 

14 health or medical benefits to such plan participants in ex15 cess of a predetermined level set forth in the stop-loss policy 

16 obtained by such plan or sponsor.’’. 

Æ 


sradovich on DSK3GMQ082PROD with BILLS