AZ| Arizona Regulatory Bulletin 2025-08 clarifies requirements for insurers selling stop loss products in the state, stating these products are not regulated as group health insurance and do not require a specific line of authority. The Arizona Department of Insurance and Financial Institutions advises that stop loss policies should avoid provisions that affect individual health plan participants, as this could subject such policies to standard health insurance regulations. Insurers must ensure their products do not create direct relationships with individual beneficiaries and should comply with all relevant Arizona statutes.
Key Points:
- Stop loss policies are not regulated as group health insurance and can be sold under either property/casualty or life/disability authority.
- Policies must not include features that resemble traditional health insurance (e.g., medical necessity decisions, managed care elements, individual claim determinations).
- Insurers must keep the relationship strictly between the carrier and the self-funded employer, without extending coverage or obligations to individuals.
