1. A. Stop loss or excess insurance issued to a self-insurance plan must meet the following requirements.

   1. 1. The plan must include a provision stating that aggregate stop-loss or excess coverage and specific stop-loss or excess coverage may only be provided by an insurer licensed to do business in the state of Louisiana.
   2. 2. The stop-loss or excess policies must contain provisions to cover incurred, unpaid claims liability in the event of plan termination.
   3. 3. The stop-loss or excess insurer shall bear the risk of coverage for any employer participating in the self-insurance plan that becomes insolvent with outstanding contributions due.

   4. 4. The stop-loss or excess insurer shall provide coverage with rates not subject to adjustment by the stop-loss or excess insurer during the first 12 months of coverage, unless:

      1. a. there is a change in the benefits provided under the group health plan; and/or
      2. b. enrollment under the group health plan changes by at least 10 percent.
   5. 5. A stop loss or excess insurer must submit its proposed stop-loss or excess policy to the Commissioner of the Department of Insurance for review at least 30 days prior to the proposed self-insurance plan’s effective date and at least 30 days prior to any subsequent renewal date.

Authority Note

AUTHORITY NOTE: Promulgated by the Department of Insurance, Office of the Commissioner, in accordance with R.S. 22:2 and 22:883.

Historical Note

HISTORICAL NOTE: Promulgated by the Department of Insurance, Office of the Commissioner, LR 46:699 (May 2020).