benefit plan itself, and does not pay health care providers for medical services provided to the employees. (4) Employer-sponsored health benefit plans are regulated under the Employee Retirement Income Security Act of 1974, however, States regulate the availability and the coverage terms of stop-loss insurance coverage that employers purchase to protect company assets and to protect a fund against excess or unexpected claims losses. (5) Both large and small employers that choose to self-fund must also be able to protect company assets or a fund against excess or unexpected claims losses and States must reasonably regulate stop-loss insurance to assure its availability to both large and small employers. 303. Certain medical stop-loss insurance obtained by certain plan sponsors of group health plans not included under the definition of health insurance coverage 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 sentence: Such term shall not include a stop-loss policy obtained by a self-insured group 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. . 304. Effect on other laws Section 514(b) of the Employee Retirement Income Security Act of 1974 ( 29 U.S.C. 1144(b) ) is amended by adding at the end the following: (10) The provisions of this title (including part 7 relating to group health plans) shall preempt State laws insofar as they may now or hereafter prevent an employee benefit plan that is a group health plan from insuring against the risk of excess or unexpected health plan claims losses. . IV Small Business Flexibility Act 401. Short title This title may be cited as the Small Business Flexibility Act . 402.