Federal Agencies Continue to Focus on Self-Insurance

April 30, 2012 --The U.S. Department of Labor has just released its 2012 report on self-insured health plans. The Department is required under the PPACA to issue a report annually. Specifically, the Department is mandated to report on general information on self-insured employee health benefit plans and financial information regarding employers that sponsor such plans.

The report contrasts data from 2009 Form 5500 filings to the 2008 filings. Items discussed (based solely on reported data) are the number of plans as-well-as the number of participants in those plans. The report also looks at the number of plans who pay claims directly out of plan assets compared to those who institute a dedicated trust.

The report distinguishes between “fully” self-insured health plans (i.e. plans that do not purchase stop-loss insurance) and “partially” self-insured health plans (i.e. plans that do purchase stop-loss insurance).

The shortcomings of the Form 5500 are discussed. Specifically that plans under 100 covered lives or plans that do not pay claims out of a dedicated trust are excluded from the Form 5500 filing requirement. Additionally, that plans are allowed to file health benefits alongside other offered benefits such as disability and life coverage, which the Department claims makes it difficult to distinguish how each benefit is financed.

The complete report can be accessed through the members’ only section of the SIIA web site by clicking here.