Determining if Plan is Self-Funded on Basis of 5500 Information

[chris]

I'm trying to determine if a health plan is self-funded by looking at the 5500 information. The benefits provided are noted at Line 8b as 4A (health), 4B (life) and 4H (disability). Line 9a notes the funding arrangement and benefit arrangement (9b) as (1) 'X' Insurance and (4) 'X' General assets of the sponsor. Is the response in Line 9(a) and 9(b) generally determinative as to whether a plan is "self-funded" or not. Any help would be greatly appreciated. Thanks......

[Guest b2kates]

9b is usually the answer for funding; but also look at the Schedule A's to see if there is insurance.

Are you looking at medical or other coverage issues?

[chris]

I'm looking at medical coverage issues.

I've got the Schedule A's which basically show two different life insurance companies' information -- one company appears to handle the life insurance portion and the other company handles long term disability. However, there no Schedule A's which identify an insurance company which handles health, stop loss, HMO or PPO contracts (referring to Line 7 Part III of the Schedule A.

To clarify my original post.... does the fact that the employer/plan sponsor has checked the box for "general assets of the sponsor" mean that the plan is self-funded/self-insured as to the health/medical coverage? and not self-funded/self-insured as to the life and disability portion since it obviously has insurance coverage in place for those aspects of the plan....? Thanks.

[GBurns]

Checking the boxes means nothing. The info on 5500s is often incorrect or misleading. It is subject to the interpretation of the person filling out the form. Some people will check the box for "General Assets" because the check that is drawn for the employer's portion of the health insurance premium is from General Assets.

[chris]

Thanks for the replies thus far. I suppose requesting an SPD may tell me more....?????