Stop Loss Coverage

On June 28, 2016, Insurance Commissioner Donegan issued an order related to stop loss coverage. Effective for plan years on or after Jan. 1, 2017, stop loss coverage subject to Vermont regulation cannot impose:

  • An annual attachment point for claims incurred per individual less than $28,700 (increased from $20,000)
  • An annual aggregate attachment point for small employers less than $5,700 times the number of covered individuals (increased from $4,000), 120 percent of claims or $28,700 (increased from $20,000)—whichever is greater.

While the new order is directed at stop loss insurers, self-insured employers in Vermont who purchase stop loss coverage should understand how the order impacts their plans beginning in 2017.

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