The DOL has launched its required annual report back to Congress on self-insured well being plans. The report offers combination details about the traits of private-sector self-insured well being plans, together with variety of members, advantages provided, funding preparations, and plan property, in addition to publicly obtainable monetary details about their sponsoring employers. The 2023 report is predicated on 2020 Kind 5500 filings.

Roughly 74,100 well being plans overlaying about 78 million members filed a Kind 5500 for 2020. Of these, about 37,900 had been self-insured plans, overlaying about 35 million members. Based on a desk evaluating 2019 and 2020 knowledge, the variety of self-insured plans submitting Kind 5500 elevated by over 7,000, whereas the variety of coated members decreased by about a million. For 2020 filings, about 51% of plans had been self-insured; 43% had been absolutely insured; and 6% had been a mixture of insured and self-insured. Compared to 2018 filings, the breakdown of plan sorts primarily flipped (see our Checkpoint article). However the distribution of plan members has remained largely unchanged, with self-insured plans overlaying about 45% of members, absolutely insured plans 18%, and mixture plans 37%. Based on the report, new plans had been principally small, self-insured plans, with progress pushed by an inflow of filings by small plans collaborating in a number of employer welfare preparations (MEWAs).

The report’s appendices present additional evaluation, together with detailed details about plan funding. Appendix A notes that mixture plans (regardless of comprising 6% of plans and overlaying 37% of members) owned 55% of the group well being plan property held in trusts; consequently, this comparatively small variety of plans drove most of the report’s combination statistics. Appendix B delves into funding mechanisms and monetary metrics, analyzing funding mechanisms by plan measurement, trade, and plan life cycle stage, amongst different issues. It additionally analyzes stop-loss protection for small and enormous plans, with the caveat that as a result of stop-loss protection is reported on Kind 5500 provided that the plan is the coverage’s beneficiary or if premiums are paid from plan property, Kind 5500 filings don’t absolutely seize using stop-loss protection.

EBIA Remark: As a result of many group well being plans are exempt from submitting Kind 5500, the report doesn’t mirror the total universe of plans. Nonetheless, the info clearly reveal a rise in using self-insured well being plans. For extra info, see EBIA’s Self-Insured Well being Plans guide at Sections IV.B (“Monetary Concerns”) and IV.E (“Prevalence and Traits of Self-Insured Well being Plans”). See additionally EBIA’s Well being Care Reform guide at Part XXXVI.E (“Annual Report on Self-Insured Plans (Utilizing Info From Kind 5500s)”) and EBIA’s ERISA Compliance guide at Part XXII.B (“Essential Kind 5500 Exemptions for Small Unfunded and/or Insured Plans”).

Contributing Editors: EBIA Workers.