IB 
Union Calendar No. 88 
118TH CONGRESS 
1ST SESSION H. R. 2813 
[Report No. 118–114, 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 stop- 
loss insurance obtained by certain plan sponsors of group health plans, 
and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
APRIL 25, 2023 
Mr. GOOD of Virginia (for himself and Mr. WALBERG) introduced the fol-
lowing bill; which was referred to the Committee on Education and the 
Workforce, and in addition to the Committees on Energy and Commerce, 
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 
JUNE 20, 2023 
Additional sponsor: Mr. SMUCKER 
JUNE 20, 2023 
Reported from the Committee on Education and the Workforce with an 
amendment 
[Strike out all after the enacting clause and insert the part printed in italic] 
VerDate Sep 11 2014 
23:58 Jun 20, 2023
Jkt 039200
PO 00000
Frm 00001
Fmt 6652
Sfmt 6652
E:\BILLS\H2813.RH
H2813
kjohnson on DSK79L0C42PROD with BILLS
JUNE 20, 2023 
Committees on Energy and Commerce and Ways and Means discharged; com-
mitted to the Committee of the Whole House on the State of the Union 
and ordered to be printed 
[For text of introduced bill, see copy of bill as introduced on April 25, 2023] 
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, and for other purposes. 
VerDate Sep 11 2014 
23:58 Jun 20, 2023
Jkt 039200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6652
E:\BILLS\H2813.RH
H2813
kjohnson on DSK79L0C42PROD with BILLS
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: 
(1) Small and large employers offer health ben-
efit plan coverage to employees in self-funded arrange-
ments 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 financial 
risk management tool to protect against excess or un-
expected catastrophic health plan claims losses that 
arise above projected costs paid out of company as-
sets. 
(3) Stop-loss coverage insures the employer spon-
soring the health benefit plan against unforeseen 
health plan claims, does not insure the employee 
health benefit plan itself, and does not pay health 
care providers for medical services provided to the 
employees. 
VerDate Sep 11 2014 
23:58 Jun 20, 2023
Jkt 039200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6203
E:\BILLS\H2813.RH
H2813
kjohnson on DSK79L0C42PROD with BILLS
(4) Employer-sponsored health benefit plans are 
regulated under the Employee Retirement Income Se-
curity Act of 1974, however, States regulate the avail-
ability and the coverage terms of stop-loss insurance 
coverage that employers purchase to protect company 
assets and to protect a fund against excess or unex-
pected claims losses. 
(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 Income 
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-in-
sured group health plan or a plan sponsor of a group health 
plan that self-insures the health risks of its plan partici-
pants to reimburse the plan or sponsor for losses that the 
VerDate Sep 11 2014 
23:58 Jun 20, 2023
Jkt 039200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6203
E:\BILLS\H2813.RH
H2813
kjohnson on DSK79L0C42PROD with BILLS
plan or sponsor incurs in providing health or medical bene-
fits to such plan participants in excess of a predetermined 
level set forth in the stop-loss policy obtained by such plan 
or sponsor.’’. 
SEC. 4. EFFECT ON OTHER LAWS. 
Section 514(b) of the Employee Retirement Income Se-
curity Act of 1974 (29 U.S.C. 1144(b)) is amended by add-
ing at the end the following: 
‘‘(10) The provisions of this title (including part 7 re-
lating to group health plans) shall preempt State laws inso-
far as they may now or hereafter prevent an employee ben-
efit plan that is a group health plan from insuring against 
the risk of excess or unexpected health plan claims losses.’’. 
Amend the title so as to read: ‘‘A bill to amend the 
Employee Retirement Income Security Act of 1974 to ex-
clude from the definition of health insurance coverage 
certain medical stop-loss insurance obtained by certain 
plan sponsors of group health plans, and for other pur-
poses.’’. 
VerDate Sep 11 2014 
23:58 Jun 20, 2023
Jkt 039200
PO 00000
Frm 00005
Fmt 6652
Sfmt 6201
E:\BILLS\H2813.RH
H2813
kjohnson on DSK79L0C42PROD with BILLS
Union Calendar No. 88 
118TH CONGRESS 
1ST SESSION 
H. R. 2813 
[Report No. 118–114, Part I] 
A BILL 
To amend the Employee Retirement Income Secu-
rity Act of 1974, the Public Health Service Act, 
and the Internal Revenue Code of 1986 to ex-
clude from the definition of health insurance cov-
erage certain medical stop-loss insurance ob-
tained by certain plan sponsors of group health 
plans, and for other purposes. 
JUNE 20, 2023 
Reported from the Committee on Education and the 
Workforce with an amendment 
JUNE 20, 2023 
Committees on Energy and Commerce and Ways and 
Means discharged; committed to the Committee of the 
Whole House on the State of the Union and ordered 
to be printed 
VerDate Sep 11 2014 
23:58 Jun 20, 2023
Jkt 039200
PO 00000
Frm 00006
Fmt 6651
Sfmt 6651
E:\BILLS\H2813.RH
H2813
kjohnson on DSK79L0C42PROD with BILLS