In March 2011, as required by the Affordable Care Act, the Secretary of Labor provided the first Annual Report to Congress on Self-Insured Group Health Plans (the “Report”). Using 2008 Form 5500 data, the DOL estimated that 12,000 health plans were completely “self-insured” covering 22 million participants and holding assets of $35 billion. Additionally, 5,000 health plans were “mixed” (self-insured with an insurance component) covering 25 million participants and holding $84 billion in assets. Besides providing aggregate data, the Report’s summary noted “the limited scope of such data” and “the complexities involved in interpreting” such data. The Report stated limitations include the following:
- Because smaller private-sector plans that do not hold assets in trust and plans covering government employees are not required to file a Form 5500, this data in not included in the Report.
- Self-insured plans are only required to file financial information for assets held in trust. As a result, the aggregate data does not reflect amounts that are paid directly from the plan sponsor’s general assets.
- Because health benefits such as medical, disability and life can be reported on a single Form 5500, it is difficult to distinguish how the benefits are financed making the “estimates presented . . . subject to substantial uncertainty.”
- The Form 5500 does not collect data on plan sponsor’s finances.
Because self-insured plans cover more than 45 million participants and hold over $119 billion in trust, it will be interesting to monitor whether Congress takes any additional regulatory action with respect to these plans. We will continue to monitor the Affordable Care Act and its new reporting requirements.