by Guest » Tue Aug 26, 2008 11:19 am
Hi All,
Why should an employer opt for a self insured plan? Can an employer with limited workforce apply for this kind of policy? Would it be beneficial for him?
Denny
Why should an employer opt for a self insured plan? Can an employer with limited workforce apply for this kind of policy? Would it be beneficial for him?
Denny
Posted: Tue Nov 17, 2009 09:35 pm Post Subject: self insured plans
If an employer "fails" and is closed down and taken over by a bank, what happens to employee claims that have been filed and are pending under his employer's self-insured plans?
Posted: Sun Nov 22, 2009 10:20 pm Post Subject: Self Insurance
Most self insured plans are set up by very large employers or groups of employers. Sometimes it makes sense for a very large company to self insure. The drawback is an adequate amount of reserves to satisfy state requirements. To Fatman: With self insurance, you are setting yourself up as an insurance company and you need to be prepared to pay out claims, as an insurance company would. One big hit could put you out of business and liable for any underfunded losses, as well as put you below minimum reserves for the state.
Thanks for the great topics and keep the good stuff flowing!
Posted: Fri Apr 22, 2011 12:37 pm Post Subject: Self insured overrides
Assuming the benefits are there. If a Self Insured plan uses a TPA and the TPA denies autorization for an employee or dependant seeking residential substance abuse treatment, can the employer override that denial and require the TPA to autorize the use of those benefits? if not how does that work?
Posted: Thu Apr 26, 2012 06:30 am Post Subject:
Self-insured group health plans are tightly-regulated so you don't have to worry as such plans can provide good health insurance benefits.
Posted: Sat Apr 28, 2012 11:53 pm Post Subject:
Self-insured group health plans are tightly-regulated
More proof that "medix" has no clue about what he is writing. There are almost no regulations that apply to non-insured self-funded group health plans -- although Obamacare will have some additional impacts. Employers are generally free to cover or not cover whatever they want, although certain things, like maternity care and coverage for women's health issues such as breast cancer are required.
About the only thing that ERISA requires is non-discrimination. Additionally, ERISA prevents most legal action against such plans by participants or beneficiaries. Non-insured self-funded plans are COMPLETELY EXEMPT from state insurance laws which generally MORE TIGHTLY REGULATE the insurance industry.
Add your comment