STATEMENT TO

[Second Reprint]

SENATE, No. 3270

with Senate Floor Amendments

(Proposed by Senator POU)

ADOPTED: JANUARY 9, 2020

      The amendments provide that, in order to be sold to a small employer in this State, a stop loss policy must establish a per person attachment point or retention or aggregate attachment point or retention, or both, which meet the following requirements:   (1) If the policy establishes a per person attachment point or retention, that specific attachment point or retention may not be less than $40,000 for all stop loss insurance policies written, issued, administered or renewed on or after April 1, 2020; and  (2) If the policy establishes an aggregate attachment point or retention, that aggregate attachment point or retention may not be less than 140% of expected claims per plan year.

      The amendments also require that, starting 2021, a stop loss insurer shall set and file its premium rates each year with the department no later than July 1 and such rates shall be immediately made public by the department.  The premium rate charged by a stop loss insurer to a group of 50 or fewer members shall comply with the small employer health benefits program rating requirements adopted by the New Jersey Small Employer Health Benefits Program pursuant to P.L.1992, c.162 (C.17B:27A-17 et seq.) and regulations at N.J.A.C.11:21-1.1 et seq. by April 1, 2020.  The commissioner shall annually review and report on the compliance with the bill.  The report shall be made available on the department’s website on or before June 30 annually.

      The amendments require a stop loss insurer to issue and renew, at the option of the small employer, a stop loss insurance policy written, issued, administered, or renewed on or after April 1, 2020, or in force on or after April 1, 2020 except in certain circumstances.