The Department of Labor recently released a report required by the national healthcare reform act that provides detailed statistics on the filing of Form 5500 by self-insured group health plans and on the sponsors of such plans. This First Annual Report to Congress on Self-Insured Group Health Plans contains general information on self-insured employee health benefit plans and financial information on the employers that sponsor them. Health benefit plans covering private- sector employees must file a Form 5500 Annual Return/Report of Employee Benefit Plan if they cover 100 or more participants or hold assets in a trust. The report presents data on such plans for 2008, the latest year for which complete data is available.
Section I of the report presents aggregate statistics describing self-insured plans that file a Form 5500.
Section II presents certain available financial information on employers that sponsor such plans.
Section III discusses certain key, qualitative differences between self-insured plans, fully- insured plans, and plans that combine self-insurance with insurance.
Section IV explains how the Form 5500 reporting requirements affect the scope of the data presented in this report.
Section V provides the conclusion.
Appendix A provides aggregate information on self-insured and mixed health benefit plans that are required to file the Form 5500.
Appendix B presents a study that surveys the academic literature on self-insured health plans, explores statistical issues associated with Form 5500 data, and analyzes available financial data for the employers that sponsor group health plans filing Form 5500.
The report estimates that 12,000 health plans filing Form 5500 for 2008 were self-insured and 5,000 mixed self-insurance with insurance. These plans respectively covered 22 million and 25 million participants. Many self-insured health plans do not meet the filing requirements and therefore do not file Form 5500. Therefore, it is likely that the report underestimates the total number of self-insured plans.
The Department of Labor's Employee Benefits Security Administration has updated its Affordable Care Act web page with the first annual report on self-insured group health plans, available at http://www.dol.gov/ebsa/healthreform/#5.
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This Legislative Update is provided for general informational purposes only and is not intended to be legal advice. Readers are urged to contact an attorney for legal advice or assistance.