Examples of health plans that might be self-funded but probably NOT regulated by ERISA include plans that are sponsored by:

  • Churches and/or religious organizations
  • School systems and/or school boards
  • Local government entities such as municipalities, counties, and public utilities
  • Native American tribes or reservations or entities

Some of these plans might be regulated by the State(s) in which they are located, and the State(s) could mandate or allow things such as:

  • Independent Review from state-appointed Independent Review companies
  • Added levels of appeal or different appeals processes and protocols
  • Awards of punitive damages to aggrieved plan participants

Or, some of these plan sponsors may be exempt from State regulation, meaning there is no government oversight of the plan.

ELAP currently has several NON-erisa Plans as clients.

ELAP will endeavor to handle self-funded NON-erisa plans -- we need EXTRA time:

  • To properly research the laws of the applicable state(s)
  • To be sure our services dove-tail with the mandates of the applicable state(s)
  • To be sure the laws of applicable state(s) are not too cumbersome or penal
  • To review the plan document
  • To revise our DDM Service Agreement and Plan Amendments as necessary

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