Pension & Benefits News Self-insured group health plans covered approximately 34 million participants, DOL annual report finds
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Friday, April 24, 2020

Self-insured group health plans covered approximately 34 million participants, DOL annual report finds

By Pension and Benefits Editorial Staff

The Department of Labor (DOL) has released to Congress its tenth annual report on self-insured group health plans with data from Form 5500, Annual Return/Report of Employee Benefit Plan, as well as data from certain financial filings of self-insured employers. Approximately 57,800 group health plans filed a Form 5500 for 2017 (the most recent complete data available), an increase of more than 3 percent from the number of plans that filed a Form 5500 for 2016. Of plans that filed a 2017 Form 5500, about 23,500 were self-insured and 3,800 mixed self-insurance with insurance (“mixed-insured”).

The IRS and the DOL developed Form 5500 for employee benefit plans to satisfy annual reporting requirements under ERISA and the Tax Code. The Patient Protection and Affordable Care Act (ACA) requires the DOL to prepare an annual report about self-insured group health plans filing Form 5500. Generally, sponsors of self-insured plans pay their plans’ covered health expenses directly, as the plans incur claims.

Number of participants. Overall, the approximately 23,500 self-insured group health plans that filed a 2017 Form 5500 covered about 34 million participants, 30 million of whom were active participants. The 3,800 mixed-insured group health plans that filed a 2017 Form 5500 covered approximately 26 million participants, 23 million of whom were active participants.

In general, plans covering a larger number of participants are more likely to be self-insured than plans with fewer participants. While 53 percent of plans were fully insured, only 19 percent of participants were covered by these plans.

SOURCE: Annual Report to Congress on Self-Insured Group Health Plans, March 2020.

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