A BILL TO BE ENTITLED
AN ACT to prohibit certain stop‑loss insurance for employers with fewer than twenty employees, unless the employer provides a medical home for its employees.
The General Assembly of North Carolina enacts:
SECTION 1.  G.S. 58‑50‑130(a)(5) reads as rewritten:
"(5)	Notwithstanding any other provision of this Chapter, no small employer carrier, insurer, subsidiary of an insurer, or controlled individual of an insurance holding company shall act as an administrator or claims paying agent, as opposed to an insurer, on behalf of small groups which, if they purchased insurance, would be subject to this section. No small employer carrier, insurer, subsidiary of an insurer, or controlled individual of an insurance holding company shall provide stop loss, catastrophic, or reinsurance coverage to small employers that does not comply with the underwriting, rating, and other applicable standards in this Act. No insurer shall issue a specific stop‑loss policy at an amount less than sixty thousand dollars ($60,000) per covered life or any aggregate stop‑loss policy to a self‑insured small employer with 20 or fewer eligible employees unless the self‑insured small employer provides for its employees a medical home that provides health care screenings, is focused on outcomes and key performance indicators, and is reimbursed on an outcomes rather than fee‑for‑service basis."
SECTION 2.  This act becomes effective October 1, 2013, and applies to stop‑loss policy contracts entered into, amended, or renewed on or after that date.