{"data":{"id":"us-dc/d.c.-code-31-3821","jurisdiction":"us-dc","citation":"D.C. Code § 31-3821","heading":"Definitions.","body":"For the purposes of this chapter, the term:\n\n(1)\n“Aggregate attachment point” means the total amount of health claims incurred by a small employer in a policy year for all covered employees and their dependents, and covered by a stop-loss insurance policy, above which the stop-loss insurer incurs a liability for payment under aggregate stop-loss coverage.\n\n(2)\n“Attachment point” means the claims amount incurred by an insured group beyond which the insurer incurs a liability for payment.\n\n(3)\n“Commissioner” means the Commissioner of the Department of Insurance, Securities and Banking.\n\n(4)\n“Expected claims” means the total amount of claims that, in the absence of medical stop-loss insurance, are projected to be incurred by the insured using reasonable and accepted actuarial principles in a policy year.\n\n(5)\n“Individual attachment point” means the amount of health claims incurred by a small employer in a policy year for an individual employee or dependent of an employee, and covered by a stop-loss insurance policy, above which the stop-loss insurer incurs a liability for payment, under individual stop-loss coverage.\n\n(6)\n“Stop-loss insurance” means coverage that insures an employer or an employer-sponsored health plan against the risk that:\n(A)\nOne claim will exceed a specific dollar amount; or\n(B)\nThe entire loss of a self-insurance plan will exceed a specific dollar amount.","path":["Title 31. Insurance and Securities.","Chapter 38A. Stop-loss Insurance for Employers."],"source_url":"https://code.dccouncil.gov/us/dc/council/code/sections/31-3821","current_through":"2026-08-20 (D.C. Law 26-175)","vintage":"","retrieved_at":"2026-08-29T05:44:07Z","sha256":"a5050006c82acbf123cc4c8d3bf2c703512b1d34bde0b00ef672fee01adfbf25","source_id":"us-dc","stale":false,"prev":"us-dc/d.c.-code-31-3805","next":"us-dc/d.c.-code-31-3822"},"notice":"GroundRules: Original legal text. Not legal advice."}