Newly Published Pieces Summarize How Self-Funded Benefit Plans Are Regulated

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The Self-Funding Success website has published two new pieces to provide an overview of how self-funded health plans are regulated. This content is part of a larger collection of resources that educates consumers about the way the self-funding benefit structure works.

Self-Funding Success Website
As employers look into the feasibility of self-funding for their business, it is important to understand how these plans are regulated.

Designed to be an informational tool for consumers who are exploring how self-funded health benefits work, the Self-Funding Success website has recently published two new resources.

Understanding ERISA & Fiduciary Duty and Self-Funding: State vs. Federal Mandates examine the basics related to the regulatory side of self-funded plans and different aspects of enforcement. These pieces explain the fact that ERISA serves as the principal federal law governing private employer self-funded plans, and describe how federal requirements preempt state rules, except when public employers sponsor self-funded plans.

Content for the site is developed by a network of third party administrators (TPAs) who specialize in the administration of self-funded health plans for companies of all sizes and is developed on a regular basis.

“As employers look into the feasibility of self-funding for their business, it is important to understand how these plans are regulated,” said Caroline Fraker, a Self-Funding Success contributor and TPA with MedBen. “Many of our pieces have focused on the wide range of advantages self-funding can offer, but as TPAs, we also feel it is essential to educate consumers on which entities govern them.”

The first new piece introduces ERISA along with a sampling of the key health plan guidelines the law sets forth. It also outlines the concept of fiduciary duty, with information on this law being the ultimate consumer protection, who is considered a fiduciary and the way fiduciary standards are enforced.

Reviewing the topic of state versus federal mandates, the second piece touches on the regulation of self-funded plans for private and public employers. Readers learn how self-funding for the former group is generally subject to federal mandates only, and see the type of benefits this can provide in terms of keeping benefits consistent at multi-state locations, eliminating state premium taxes and more.

“When developing content, our TPA contributors are trying to look at self-funding from all different angles,” Fraker said. “The regulatory aspect is an important consideration, and we want consumers to have an accurate overview of it.”

Self-Funding Success is an initiative designed to educate the public about how self-funded health plans work and the ways employers are having success with them. It is organized by a group of third party administrators (TPAs) from across the U.S. For more information, visit

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Dave Willems
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