Employers with self-insured health plans may be thinking about making coronavirus (COVID-19)-related changes, such as waiving the patient responsibility portion of the charge for a hospital stay that is related to COVID-19. If there is stop loss insurance, it is important to consider the implications of a plan design change. Many stop loss policies require that the insurer sign off on any design changes to the plan, or exclude payment for treatments or plan costs that are outside of the specifications provided in the policy application. The takeaway is that if you are thinking of making design changes to your self-insured health plan and there is stop loss insurance, it may be important to get advance sign-off from the stop loss insurer, or at least obtain an understanding of the implications if the insurer declines to sign off.