Bill > H156

This bill modifies North Carolina's insurance regulations to expand access to stop loss insurance for small employers by lowering the minimum number of eligible employees from 12 to five. Stop loss insurance is a type of coverage that protects employers who self-fund their health insurance plans by reimbursing them for catastrophically high medical claims. The bill maintains several existing restrictions on stop loss insurance, including requirements that policies cannot have an annual per-individual claims attachment point lower than $20,000 and an annual aggregate attachment point lower than either 120% of expected claims or $20,000. These attachment points will continue to be indexed to the Consumer Price Index for Medical Services. The bill also preserves language allowing insurers to provide incentives for small employers that promote medical homes, health screenings, and outcome-based healthcare. The changes will become effective on October 1, 2025, and will apply to insurance contracts issued, renewed, or amended on or after that date, potentially giving small employers with fewer than 12 employees more opportunities to access stop loss insurance coverage.

Business and Industry, Government Affairs, Health and Social Services

https://www.ncleg.gov/BillLookUp/2025/H156