What does Preamble of Self-Insurance Protection Act do?

This bill proposes to amend the Employee Retirement Income Security Act of 1974. The proposed amendment would exclude certain medical stop-loss insurance from the definition of health insurance coverage. This exclusion applies to medical stop-loss insurance obtained by certain plan sponsors of group health plans.

What does SHORT TITLE. of Self-Insurance Protection Act do?

This Act is formally titled the 'Self-Insurance Protection Act'.

What does FINDINGS. of Self-Insurance Protection Act do?

Employers, both small and large, offer health benefit plan coverage to employees through self-funded arrangements or by purchasing fully-insured coverage. Employers using self-funded arrangements often purchase stop-loss insurance to manage financial risk from unexpected claims. Stop-loss insurance protects the employer sponsoring the health benefit plan, not the plan itself or healthcare providers. Employer-sponsored health benefit plans are regulated under the Employee Retirement Income Security Act of 1974. States regulate the availability and terms of stop-loss insurance coverage. Both large and small self-funded employers need to protect assets against claims losses, and States should reasonably regulate stop-loss insurance.

What does CERTAIN MEDICAL STOP-LOSS INSURANCE OBTAINED BY CERTAIN PLAN of Self-Insurance Protection Act do?

This section amends Section 733(b)(1) of the Employee Retirement Income Security Act of 1974. The amendment excludes certain stop-loss policies from the definition of 'health insurance coverage'. Specifically, the exclusion applies to stop-loss policies obtained by self-insured group health plans or plan sponsors. These plans or sponsors must self-insure the health risks of their plan participants. The stop-loss policies must reimburse the plan or sponsor for losses exceeding a predetermined level.

What does EFFECT ON OTHER LAWS. of Self-Insurance Protection Act do?

This bill amends the Employee Retirement Income Security Act of 1974. The amendment adds a provision to Section 514(b) regarding preemption of State laws. The added provision states that group health plans can preempt State laws that prevent insuring against unexpected health claims losses.

Back to bills

Self-Insurance Protection Act

Last updated: 12/15/2025 · Introduced: 4/1/2025

Author: Robert Onder (R-MO)

TL;DR (AI)

The bill excludes certain medical stop-loss insurance policies from the definition of 'health insurance coverage' under ERISA.
It allows self-insured group health plans to preempt state laws that restrict insurance against unexpected health claims losses.
The legislation aims to protect employers who self-fund health benefit plans by allowing them to obtain stop-loss insurance to manage financial risk.

119th Congressin committeeOfficial page

Verified Votes

No verified votes yet.

Community Votes

No community votes yet. Be the first!

Voting as guest · Sign in for verified votes

Other Sections

Includes provisions on preamble, short title., and 3 more.

5 sections

Click "Show details" to explore individual sections. Use the community vote above or visit All Sections to vote per section.

Read official text

Want the full experience?

Create a free account to cast verified votes on each section, get a personalized summary, and track your voting history.

Create Free Account