Self-funded health plan

[Guest Melissa Winslow]

I need some guidance on if/how I need to file for my employers health plan.

According to documents received from the insurance company, our plan is a self-funded group contract. We pay the insurance company a "premium/fee" each month based on the number of employees we have. A portion of this fee is funded by our employees. And, we are billed monthly for the benefit checks the insurance company writes each month. We have about 25 employees.

According to 29CFR 2520.104-20, it would seem that we may be exempt from filing form 5500. However, I'm not sure that reimbursing the insurance company for claims paid qualifies us under item (B)(2)(ii) of that section (discusses benefits being paid solely from the general assets of the employer). I am leaning towards being exempt since it would seem we are just hiring the insurance company to administer the plan rather than having them "fund" it.

Any thoughts?

[Guest Emiliano]

It seems like you meet b(2)(i) of that section. You could call the US Dept of Labor 5500 Assistance Center at (202) 693-8360 for a better explanation.