Number Of Self-Insured Plans Decreased From 2009 To 2010: EBSA

Of the approximately 49,000 health plans that filed a Form 5500 for 2010 (a decrease of more than three percent from 2009), about 19,800 were self-insured (down from 20,400 in 2009) and around 4,000 were mixed-insured (down from 4,100), according the Department of Labor’s (DOL) Employee Benefits Security Administration (EBSA). The EBSA cautions, however, that since many self-insured health plans do not file the Form 5500 because they do not meet the filing requirements, the figures in the latest DOL report, the creation of which was established by the Patient Protection and Affordable Care Act (ACA), probably underestimate the total number of self-insured plans.

Sponsors of fully-insured plans transfer health expense risks, along with premium payments, to insurance companies, as opposed to sponsors of self-insured plans, which are those in which the plan sponsor retains the risk associated with paying covered health expenses. Mixed-funded plans are those in which the sponsors retain the risk for a subset of benefits and transfer the risk for remaining benefits to health insurers.

Apparently, anomalies were discovered in Form 5500 filings, and, for its 2013 Annual Report to Congress on Self-Insured and Group Health Plans, the EBSA was tasked with collecting supplemental data from some of the filers, who were asked to clarify ambiguities in their forms. The EBSA discovered that the algorithm used to estimate funding mechanisms from Form 5500 filings for the 2012 report identified too many fully insured or mixed-funded plans and too few self-insured plans. The algorithm was revised for the 2013 report, and currently represents the DOL’s best estimates of plan funding arrangements for 2010 and earlier years.

According to the report, in 2010, self-insured plans covered approximately 30 million participants, and they held assets totaling about $58 billion. Nearly 26 million participants were covered by mixed-funded plans in 2010, and these plans held assets of more than $136 billion.

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