The Self-Insurance Insurance Institute of America Inc. (SIIA) is blasting allegations by federal regulators and others who contend that employer flight to the self-insured market could leave insured plans stuck with the sickest employees.
The Patient Protection and Affordable Care Act of 2010 (PPACA) exempts self-funded employers from most of the provisions that apply to insured health plans. The large and midsize employers that offer self-insured plans will have to provide coverage for employees or pay a penalty, but the self-insured plan sponsors will not be subject to the PPACA essential benefits package requirements or the new requirement that insurers offer several specific levels of coverage.
The stop-loss carriers that reinsure the self-funded plans to not have to abide by the new PPACA fee-increase justification requirements, and self-insured plans also will also be exempt from a new tax that PPACA is set to impose on health insurers.
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