S.6917 (Seward) / A.9980 (Cahill)


Director of Government Affairs


S.6917 (Seward) / A.9980 (Cahill)


Redefines "small group" for the purposes of maintaining the stop loss insurance market



The Business Council supports this bill that would redefine “small group” for the purpose of allowing employers with 51 or more employees to purchase stop loss insurance and avail themselves to third-party administrative services for self-funded health insurance.

Starting in 2016, the federal Affordable Care Act's definition of “small group,” which includes businesses employing up to 100 employees, would effectively prohibit insurers from continuing to be able to issue stop loss coverage to groups with between 51 and 100 employees.

Self-insurance is an important alternative for businesses because it provides them with increased flexibility, the ability to design their own plan and in some instances, a less expensive alternative to purchasing health insurance. Small employers, who self-insure, typically hire an outside, third-party to manage their plans. They also purchase stop-loss insurance to protect themselves from the potential of unusually high health claims.

Many of New York's small employers and their employees alike have been enjoying the benefits of self-insurance and need and deserve the ability to keep their current plans. This bill would allow the current stop loss marketplace to continue to operate as it currently does in 2016 and beyond, thus allowing employers with over 50 employees to have the same options for health insurance coverage for their employees as they do today.

For these reasons, The Business Council supports approval of S.6917 / A.9980.