Section 89.474. Prohibited activities

An individual or entity, including third-party administrators, that places stop-loss coverage through an insurer or other entity not licensed to issue stop-loss coverage in this Commonwealth may be found to be in violation of provisions of The Insurance Department Act of one thousand nine hundred and twenty-one (40 P. S. § § 1—297.4) that prohibit unlicensed agent activity. Stop-loss coverage may only be issued by licensed Pennsylvania insurers through their licensed agents or brokers. Other entities who receive, or attempt to receive, a fee, commission or other compensation in connection with the issuance of stop-loss coverage may be found to be in violation of provisions of The Insurance Department Act of one thousand nine hundred and twenty-one that prohibit unlicensed insurance activity. Further, stop-loss coverage may only be issued to valid single employer self-funded ERISA qualified plans, unless the Commissioner determines that other plans may be eligible for the coverage.

The provisions of this § 89.474 adopted September 25, 1992, effective September 26, 1992, 22 Pa.B. 4785.