"It's not obvious to me that macro economic trends affect employer decisions to self-insure
, but I do believe that disruptions in the health care marketplace caused in part by the ACA certainly have had an effect, " says Mike Ferguson, president and CEO of the Self-Insurance Institute of America.
According to DoL's November guidance, in general, private sector employment-based group health plans that self-insure
are not subject to some of requirements under the ACA that apply only to health insurance issuers, but are subject to consumer protections in the group market reform provisions, such as the prohibition on lifetime and annual limits, prohibition on pre-existing condition exclusions, and coverage of dependents to age 26.
(18) Lastly, the statute authorizes the director to allow licensed medical professionals and providers to self-insure
as long as they possess sufficient financial resources.
In this study, we describe how we have modeled the firm decision to self-insure
in the face of different stop-loss options after implementation of the ACA.
A Despite the rising cost of health care in the U.S., many people think they can self-insure
for their long-term care needs.
It has been suggested that some small employers with healthier employees may self-insure
and purchase stop loss insurance policies with relatively low attachment points to avoid being subject to the regulation that regular health insurance policies are subject to under the Patient Protection and Affordable Care Act and state law regarding rates, coverage and other matters.
The federal government is developing extensive data reporting requirements that must weigh in any risk manager's decision to self-insure
or to administer a self-insured retention.
Some public-sector members have elected to self-insure
many of their liability exposures, such as automobile, general liability, even employment practice liability.
According to the Daily Telegraph, promoter AEG Live has lined up insurance for the first 10 dates, but may be forced to self-insure
the rest of the performances at the O2 arena between July and February.
"I can afford to self-insure
in the event that I need long term care."
Large multinational companies self-insure
the following lines of coverage via a captive: general liability, workers' compensation, employee benefits and property insurance.
(Public sector employers, while not technically covered by ERISA, frequently self-insure
for health benefits and operate similarly to self-insured private sector employers.)