Pension & Benefits News Self-insured group health plans covered approximately 35 million participants, DOL annual report finds
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Wednesday, April 14, 2021

Self-insured group health plans covered approximately 35 million participants, DOL annual report finds

By Pension and Benefits Editorial Staff

The Department of Labor (DOL) has released to Congress its 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 60,500 group health plans filed a Form 5500 for 2018 (the most recent complete data available), an increase of nearly 5 percent from the number of plans that filed a Form 5500 for 2017. Of plans that filed a 2018 Form 5500, about 25,500 were self-insured and 4,100 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 25,500 self-insured group health plans that filed a 2018 Form 5500 covered about 35 million participants, 31 million of whom were active participants. The 4,100 mixed-insured group health plans that filed a 2018 Form 5500 covered approximately 28 million participants, 24 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 51 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 2021.

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