ERISA Regulation of Health Plans: Fact Sheet
Hinda Chaikind
Abstract
Open-access reader
Hinda Chaikind
Abstract
Open-access reader
The Employee Retirement Income Security Act of 1974 (ERISA, P.L. 93-406) places the regulation of employee benefit plans (including health plans) primarily under federal jurisdiction for about 124 million people. ERISA’s treatment of health plans is both complicated and confusing. ERISA has been interpreted as dividing health plans into two groups regulated differently under the law: about 54 million people are covered by self-insured plans for which the employer, rather than an insurer, assumes the risk for paying for covered services and about 70 million people are covered by purchased insurance (according to 2000 information from the Census Bureau and the Department of Labor).
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The Employee Retirement Income Security Act of 1974 (ERISA, P.L. 93-406) places the regulation of employee benefit plans (including health plans) primarily under federal jurisdiction for about 124 million people. ERISA’s treatment of health plans is both complicated and confusing. ERISA has been interpreted as dividing health plans into two groups regulated differently under the law: about 54 million people are covered by self-insured plans for which the employer, rather than an insurer, assumes the risk for paying for covered services and about 70 million people are covered by purchased insurance (according to 2000 information from the Census Bureau and the Department of Labor).
Key concepts: Employee Retirement Income Security Act, Jurisdiction, Business, Census, Health insurance, Actuarial science, Employee benefits, Law