In the US, do companies which self-insure for the health care plans they offer employees have any duty to make a publicly accessible financial report on their health care plans? That is to say - are they required by any law to report on their income (premiums) and expenditures (paid claims) and the resultant profit or loss?

For instance - say that Mc'Neal Tires Inc. has Healthxco Inc. administer its company health care plan, and they self insure. Employees pay premiums which go to Mc'Neal Tires Inc., employees submit claims to Healthxco Inc. who decide whether to approve and pay or deny claims, and approved and paid claims are billed to Mc'Neal (possibly with some mark-up or additional fees, as negotiated between Mc'Neal Tires and Healthxco). Would Mc'Neal Tires Inc. have to publish a financial report on the plan? Would Healthxco Inc.? If Healthxco, would they have to report their business with Mc'Neal Tires Inc. separately, or could they file one report that includes all the business they do?

  • I don't know, though I suspect the answer is no. I am pretty sure that these plans are governed by ERISA, though, so you might want to look there if you haven't already. – phoog Mar 2 '16 at 4:06

Your Answer

By clicking “Post Your Answer”, you agree to our terms of service, privacy policy and cookie policy

Browse other questions tagged or ask your own question.