; and (B) transportation primarily for and essential to receiving items and services referred to in subparagraph (A). (11) Person The term person includes a State or unit of local government. (12) State The term State includes the several States, the District of Columbia, Puerto Rico, the Virgin Islands of the United States, Guam, American Samoa, and the Commonwealth of the Northern Mariana Islands. (c) Effective date This section shall take effect on the date of the enactment of this Act and shall not apply with respect to conduct occurring before such date. 602. Certain medical stop-loss insurance obtained by certain plan sponsors of group health plans not included under the definition of health insurance coverage (a) PHSA Section 2791(b)(1) of the Public Health Service Act ( 42 U.S.C. 300gg–91(b)(1) ) is amended by adding at the end the following new sentence: Such term shall not include a stop loss policy obtained by a self-insured health plan or a plan sponsor of a group health plan that self-insures the health risks of its plan participants to reimburse the plan or sponsor for losses that the plan or sponsor incurs in providing health or medical benefits to such plan participants in excess of a predetermined level set forth in the stop loss policy obtained by such plan or sponsor. . (b) ERISA Section 733(b)(1) of the Employee Retirement Income Security Act of 1974 ( 29 U.S.C. 1191b(b)(1) ) is amended by adding at the end the following new sentence: Such term shall not include a stop loss policy obtained by a self-insured health plan or a plan sponsor of a group health plan that self-insures the health risks of its plan participants to reimburse the plan or sponsor for losses that the plan or sponsor incurs in providing health or medical benefits to such plan participants in excess of a predetermined level set forth in the stop loss policy obtained by such plan or sponsor. . (c) IRC Section 9832(b)(1)(A) of the Internal Revenue Code of 1986 is amended by adding at the end the following new sentence: Such