Comments on: :: How To Identify A Self-Funded ERISA Plan http://www.healthplanlaw.com/?p=181 ERISA Group Health Plan Administration Thu, 12 Aug 2010 17:18:07 -0600 http://wordpress.org/?v=2.8.6 hourly 1 By: Don Levit http://www.healthplanlaw.com/?p=181&cpage=1#comment-290 Don Levit Mon, 06 Nov 2006 18:50:20 +0000 http://healthplanlaw.com/?p=181#comment-290 Roy: Was this a response? If so, could you provide the text? Don Levit Roy:
Was this a response?
If so, could you provide the text?
Don Levit

]]> By: Health Plan Law - ERISA Group Health Plan Administration » :: How To Identify An Exempt Governmental Plan http://www.healthplanlaw.com/?p=181&cpage=1#comment-287 Health Plan Law - ERISA Group Health Plan Administration » :: How To Identify An Exempt Governmental Plan Mon, 06 Nov 2006 17:41:58 +0000 http://healthplanlaw.com/?p=181#comment-287 [...] :: How To Identify A Self-Funded ERISA Plan [...] [...] :: How To Identify A Self-Funded ERISA Plan [...]

]]> By: Don Levit http://www.healthplanlaw.com/?p=181&cpage=1#comment-268 Don Levit Wed, 01 Nov 2006 18:43:48 +0000 http://healthplanlaw.com/?p=181#comment-268 Roy: Of course, what I think would be clearly prohibited, and what is actually prohibited can be 2 different items. When we look at the legal determination of whether a state law should be prohibited, we need to consider at least 2 items. First, states have the right to regulate insurers. In an ERISA context, this right can be be rescinded, or modified, if the state's regulation is inconsistent with ERISA. When looking at this, one should, primarily, include in the analysis the purposes why ERISA was enacted, which include protection of plan participants, as well as encouraging employers to provide ERISA plans. One of the worst violations of the purposes of ERISA that I have seen is California's passage in the 1990s of a law that disallowed future MEWAs from being formed. The purpose of the 1983 MEWA amendmenmt was to regulate MEWAs. If Congress wished them to be abolished, they could have done so. Don Levit Roy:
Of course, what I think would be clearly prohibited, and what is actually prohibited can be 2 different items.
When we look at the legal determination of whether a state law should be prohibited, we need to consider at least 2 items. First, states have the right to regulate insurers. In an ERISA context, this right can be be rescinded, or modified, if the state’s regulation is inconsistent with ERISA. When looking at this, one should, primarily, include in the analysis the purposes why ERISA was enacted, which include protection of plan participants, as well as encouraging employers to provide ERISA plans.
One of the worst violations of the purposes of ERISA that I have seen is California’s passage in the 1990s of a law that disallowed future MEWAs from being formed. The purpose of the 1983 MEWA amendmenmt was to regulate MEWAs. If Congress wished them to be abolished, they could have done so.
Don Levit

]]> By: Roy F. Harmon III http://www.healthplanlaw.com/?p=181&cpage=1#comment-267 Roy F. Harmon III Wed, 01 Nov 2006 15:52:11 +0000 http://healthplanlaw.com/?p=181#comment-267 Don, Let's focus on the plan, not the stop loss insurance, since the plan is (or should be) the source of benefit obligations. Now, you say "states cannot regulate plans as if they were insurers, including MEWAs . . ." In the MEWA context, give me an example of a State insurance requirement that would be clearly prohibited by ERISA as applied to a MEWA. Roy Don,

Let’s focus on the plan, not the stop loss insurance, since the plan is (or should be) the source of benefit obligations.

Now, you say “states cannot regulate plans as if they were insurers, including MEWAs . . .” In the MEWA context, give me an example of a State insurance requirement that would be clearly prohibited by ERISA as applied to a MEWA.

Roy

]]> By: Don Levit http://www.healthplanlaw.com/?p=181&cpage=1#comment-265 Don Levit Wed, 01 Nov 2006 15:35:47 +0000 http://healthplanlaw.com/?p=181#comment-265 Roy: This is an excellent interpretation of self-funded versus fully insured. I am curious about your thoughts regarding state regulation of a MEWA that is basically the same stop-loss ERISA plan as a single employer. Because the plan is the ultimate risk bearer, and states cannot regulate plans as if they were insurers, including MEWAs, what responsibilities does the state have toward this MEWA plan? Obviously, the state has the right to regulate the stop-loss insurer, but, from prior posts, you seemed to suggest that the stop-loss insurer would not be regulated as a health insurance issuer. So, other than solvency and fraud, how might the stop-loss insurer be regulated by the state? Don Levit Roy:
This is an excellent interpretation of self-funded versus fully insured.
I am curious about your thoughts regarding state regulation of a MEWA that is basically the same stop-loss ERISA plan as a single employer.
Because the plan is the ultimate risk bearer, and states cannot regulate plans as if they were insurers, including MEWAs, what responsibilities does the state have toward this MEWA plan? Obviously, the state has the right to regulate the stop-loss insurer, but, from prior posts, you seemed to suggest that the stop-loss insurer would not be regulated as a health insurance issuer. So, other than solvency and fraud, how might the stop-loss insurer be regulated by the state?
Don Levit

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