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- Alaska Statutes.
- Title 21. Insurance
- Chapter 42. The Insurance Contract
- Section 145. Stop-Loss Insurance Provisions.
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. Standard Provisions.
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. Policy Must Contain Entire Contract.
AS 21.42.145. Stop-Loss Insurance Provisions.
- (a) An insurance company licensed under AS 21.09, a hospital or
medical service corporation licensed under AS 21.87, a fraternal
benefit society licensed under AS 21.84, a health maintenance
organization licensed under AS 21.86, or a multiple employer
welfare arrangement may not issue a stop-loss insurance policy that
- (1) has an annual attachment point for claims incurred for each individual that is lower than $10,000;
- (2) has an annual aggregate attachment point for a small employer that is lower than the greatest of
- (A) $4,000 times the number of individuals covered under the health benefit plan;
- (B) 120 percent of the expected claims for the health benefit plan for the period covered by the stop-loss insurance
- (C) $20,000;
- (3) has an annual aggregate attachment point for a large employer that is lower than 110 percent of expected claims for
the health benefit plan for the period covered by the stop-loss insurance policy; or
- (4) provides direct coverage of health care expenses of an individual.
- (b) The director may, by regulation, change the dollar amounts established under (a) of this section to reflect medical
costs in this state, including adjustments to reflect changes in the medical care component of the Consumer Price Index
for all urban consumers for the Anchorage Metropolitan Area compiled by the Bureau of Labor Statistics, United States
Department of Labor.
- (c) For the purposes of this section,
- (1) "attachment point" means the claim amount incurred by an insured group beyond which the insurer incurs a liability for
- (2) "expected claims" means the amount of claims that, in absence of a stop-loss insurance policy or other insurance, are
projected to be incurred by an insured group through its health benefit plan;
- (3) "health benefit plan" has the meaning given in AS 21.54.500
- (4) "large employer" has the meaning given in AS 21.54.500
- (5) "small employer" has the meaning given in AS 21.54.500
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