As noted by Autismvotes, in its webpage, Information for Families With Self-Funded Health Insurance Plans
"Even in the states that have passed autism insurance reform , many children are still unable to receive treatment because they are insured through self-funded plans that are not regulated by the state. If you work for a large company or government, there is a chance your health plan is a self-funded insurance plan. For self-funded insurance plans, federal ERISA [Employee Retirement Income Security Act of 1974 (ERISA)] law preempts most state insurance regulations, including benefit reforms like autism insurance reform..."Some of the useful resources at Autismvotes are,
- Self-funded plans: Establishing an autism benefit
- How Private Health Insurance Works: A Primer
- Companies with self-insured health plans that have opted to provide coverage for autism therapies
Self-Insured Employers Cover ABA Intervention for Autism and Other Special NeedsOne other useful reference is from the State of Colorado, Division of Insurance - this has some Colorado-specific clauses, but in general is a clear, lay-friendly explanation of ERISA, self-funded plans, and information on departments in the Federal Government dealing with this area.
Laurie Stuebing, APBA Autism Task Force
APBA Reporter Issue # 3 - February, 2009.
ERISA -- Employer-sponsored Self-funded Health Benefit Plans
Colorado Division of Insurance January 2009
- What is ERISA?
- What is the difference between a health insurance plan and an employer-funded health benefit plan
- What steps can I take if I am covered under an ERISA plan and my claim is denied?
- Who has regulatory authority for ERISA plans?
- What are required procedures for Employee Welfare Benefit Plans (Self-funded Plans)?
- What is the “summary plan description” and how does it work?
- Do states have the authority to regulate Employer-sponsored Self-funded Health Benefit Plans?
- How many people in Colorado are insured under an employer-sponsored or self-funded health benefit plan (ERISA plan)?
- Who can provide more information on Employer-Funded Health Benefit Plans?
This post originally posted
Tuesday, December 22, 2009
FYI: Self-funded Health Insurance Plans and ERISA
Practitioner Issues in Behavior Analysis SIG blog
© 2010 Regina G. Claypool-Frey
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