I 
119TH CONGRESS 
1ST SESSION H. R. 2571 
To amend the Employee Retirement Income Security Act of 1974 to exclude 
from the definition of health insurance coverage certain medical stop- 
loss insurance obtained by certain plan sponsors of group health plans, 
and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
APRIL 1, 2025 
Mr. ONDER introduced the following bill; which was referred to the Committee 
on Education and Workforce 
A BILL 
To amend the Employee Retirement Income Security Act 
of 1974 to exclude from the definition of health insur-
ance coverage certain medical stop-loss insurance ob-
tained by certain plan sponsors of group health plans, 
and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Self-Insurance Protec-
tion Act’’. 
SEC. 2. FINDINGS. 
Congress finds the following: 
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(1) Small and large employers offer health ben-
efit plan coverage to employees in self-funded ar-
rangements using company assets or a fund, or by 
paying premiums to purchase fully-insured coverage 
from a health insurance company. 
(2) Employers that self-fund health benefit 
plans will often purchase stop-loss insurance as a fi-
nancial risk management tool to protect against ex-
cess or unexpected catastrophic health plan claims 
losses that arise above projected costs paid out of 
company assets. 
(3) Stop-loss coverage insures the employer 
sponsoring the health benefit plan against unfore-
seen health plan claims, does not insure the em-
ployee health benefit plan itself, and does not pay 
health care providers for medical services provided to 
the employees. 
(4) Employer-sponsored health benefit plans are 
regulated under the Employee Retirement Income 
Security Act of 1974, however, States regulate the 
availability and the coverage terms of stop-loss in-
surance coverage that employers purchase to protect 
company assets and to protect a fund against excess 
or unexpected claims losses. 
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(5) Both large and small employers that choose 
to self-fund must also be able to protect company as-
sets 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 employers. 
SEC. 3. CERTAIN MEDICAL STOP-LOSS INSURANCE OB-
TAINED BY CERTAIN PLAN SPONSORS OF 
GROUP 
HEALTH 
PLANS 
NOT 
INCLUDED 
UNDER THE DEFINITION OF HEALTH INSUR-
ANCE COVERAGE. 
Section 733(b)(1) of the Employee Retirement In-
come Security Act of 1974 (29 U.S.C. 1191b(b)(1)) is 
amended by adding at the end the following sentence: 
‘‘Such term shall not include a stop-loss policy obtained 
by a self-insured group health plan or a plan sponsor of 
a group health plan that self-insures 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 ob-
tained by such plan or sponsor.’’. 
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