SIIA Legislative & Regulatory Issue Overview

Since the beginning of the 116 Congress, SIIA’s Government Relations team has met with every member of Senate and House Committees of jurisdiction, along with other Members of Congress, totaling nearly 225 individual Hill meetings, as well as SIIA member fly-in’s.

Self-Insurance Policy

  • SIIA drafted and advocated for the introduction of the Self-Insurance Protection Act (SIPA), HR 1304, which received a hearing, mark-up and was passed by the full House in April 2017 by a vote of 400-16 and ran out of time on the Senate hotline in late-2018.
    • The legislation ensures that stop-loss insurance is not considered as health insurance for federal regulatory purposes, which would greatly restrict its availability in the marketplace.

Healthcare Cost & Transparency

  • Since last year, SIIA has been engaged with House and Senate leadership and committee staff on the issue of surprise billing and overall health price transparency, issuing numerous policy proposals and letters throughout the hearing and mark-up process.
    • In addition, SIIA has participated in both congressional and private sector coalition stakeholder meetings, as well as a number of congressional fundraising events for Hill allies.
    • SIIA has long-favored an approach to surprise medical billing that fully protects patients while implementing a fair reimbursement mechanism based on a privately-negotiated in-network median geographic rate.
  • SIIA staff and members have engaged with the White House and federal agencies as Executive Orders and rulemaking procedures are finalized within the Administration on price transparency and cost issues.
  • Since 1997, SIIA has been working with Congress to advocate for the ability of small- and medium-sized businesses to form association health plans. (AHPs). In direct advocacy and congressional testimony, meeting with Department of Labor officials, working with coalitions and providing unique self-insurance comments, SIIA has strongly advocated for the appropriate formation and availability of federally regulated AHPs to allow their formulation within and across state boundaries.

Captive Insurance Advocacy

  • SIIA led industry efforts to revise 831(b) legislative clarifying language passed as part of the 2015 omnibus tax bill (PATH Act)
    • Subsequently, SIIA successfully proposed and passed needed PATH Act technical tax clarifications to ease the limitations and burdens for captive managers and owners.
    • Created a coalition of 15 state captive insurance associations requesting guidance and clarification from the IRS and Treasury on the PATH Act, producing requests from nearly a dozen Senate offices.
  • Following the issuance of onerous captive reporting requirements under IRS Notice 2016-66 for captive managers and participants, SIIA led an industry wide campaign before Treasury and Congress to narrow the scope.
    • This is an ongoing activity with Treasury and congressional meetings. SIIA is proactively establishing narrowing scope guidelines to assist Treasury in drawing back the reporting requirements.
  • In 2019, SIIA proactively released a Captive Manager Code of Conduct, formulated by a diverse group of industry participants to provide ethical guidance to captive managers The goal was to create guidelines and inform consumers, policymakers and regulators on how to evaluate captive manager business practices, and the captive industry in general. These practices focus on tenants such as integrity, conflict of interest, confidentiality, advertising and practice management.
    • The SIIA Code was subsequently taken up by a number of state associations and is a requirement for captive managers operating in the State of Tennessee.
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