Why Choose Self-Funding

Government Compliance Help

Adhering to ERISA Regulations

As detailed in an article covering the fact that most self-funded plans are primarily subject to federal regulations, third party administrators (TPAs) are dedicated to helping employers and health plans navigate the complex and changing regulatory landscape.

The Employee Retirement Income Security Act of 1974 (ERISA) was created to be the ultimate consumer protection law. Consequently, its protections and requirements exceed many business and insurance laws. This is why it is wise to select an entity specializing in ERISA for doing your plan administration and services. TPAs were involved and provided real-world insights when ERISA was being written. TPAs have experience working with the Department of Labor’s main law for self-funding (ERISA), including provisions as they relate to:

  • Plan disclosure to participants
  • Plan reporting
  • Plan fiduciary responsibility (what can and cannot be delegated)
  • Nondiscrimination rules
  • And more

Following Other Federal Regulations

In addition to their hands-on knowledge of the many ERISA requirements and safeguards, TPAs also assist employers with compliance as it relates to the federal rules set forth by agencies such as the Department of Treasury, Department of Health and Human Services (HHS) and Equal Employment Opportunity Commission (EEOC).

Beyond this, TPAs will often go a step further and work with their clients to provide an understanding of how to meet the requirements of employer-related laws, including IRS Employer Shared Responsibility, ALE and MEC Reporting, COBRA, ADA, MSP, etc.

In offering a health plan, it can be overwhelming to manage all of the complex compliance requirements enforced by multiple agencies. This is a skill TPAs have and bring to the partnership with self-funded employers to simplify the process and fulfill the high standards set by federal laws.