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Self insured plans could be regulated as fully insured plans, says the Supreme Court

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In Kentucky Association of Health Plans v. Miller, it states:

ERISA's savings clause does not require that a state law regulate "insurance companies" or even the "business of insurance" to be saved from preemption; it need only be a law which regulates "insurance", and self insured plans engage in the same sort of risk pooling arrangements as separate entities that provide insurance to an employee benefit plan.

Both of Kentucky's AWP laws apply to all HMOs, including HMOs that do not act as insurers but instead provide only administrative services to self insured plans. Petitioners maintain that the application to noninsuring HMOs forfeits the laws' status as laws which regulate insurance. We disagree. These noninsuring HMOs would be administering self insured plans, which we think suffices to bring them within the activity of insurance for purposes of Sec. 1144(b)(2)(A).

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