- Self-insured plans must conform to the Employee Retirement Income Security Act. This act sets the minimum standards of private industry health plans. As an employer, according to ERISA, you must give your employees information about your plan including how the company manages the plan's assets, instructions for filing a grievance with the company regarding the denial of benefits, the appeals process and information about the employees' rights to sue if you do not pay qualified claims.
- As a self-insured employer, you must follow the guidelines of the Health Insurance Portability and Accountability Act. Under HIPAA, you must conform to federal laws regarding pre-existing conditions and must give employees a certificate of creditable coverage when they exit your plan. HIPAA prevents you from discriminating against employee and requires that you do not charge more, deny or exclude employees from the plan if they have a health issue.
- You must also conform to the Consolidated Omnibus Budget Reconciliation Act if you had more than 19 employees in the previous year. This act requires that you continue to provide insurance to employees for up to 18 months after they leave your employ. While you do not have to pay any of their premiums as you might do for current employees, you cannot charge them more than 102 percent of the premium price.
- Along with the regulations in your state, you must provide insurance to employees regardless of their disability according to the Americans with Disabilities Act and regardless of their age according to the Age Discrimination in Employment Act. You cannot discriminate against employees because of their color under the Civil Rights Act or, women who are pregnant, according to the Pregnancy Discrimination Act. Consult your state's insurance department to learn your state's specific guidelines that govern self-insured employers.
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