What is a “self-insured” plan?
An employer may choose to “self-insure” by paying out benefits from its own funds. Typically, an insurance company is used to administer the program, but the liability for paying for the care of the workers rests on the employer. It is important for workers to understand that if their employer “self-insures,” state patient protections (such as access to internal and external appeals processes, assurance of certain benefits, and the right to have grievances heard by the state insurance department) do not apply. All federal protections (i.e., Health Insurance Portability and Accountability Act [HIPAA] and Consolidated Omnibus Budget Reconciliation Act [COBRA]) do remain.

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1. Is my employer required to offer me health insurance coverage?
2. Can my employer change our health insurance carrier and level of benefits during the year?
3. Are all group health insurance policies regulated by the South Carolina Department of Insurance?
4. What happens to my group health coverage if I leave my employer?
5. After terminating employment, how long is my employer required to continue my insurance, and under the new federal law, isn't this coverage free and shouldn't it last forever?
6. What happens when my group health coverage ends?
7. My health insurance company has not paid my claim. What is the time frame for a company to process the claim?
8. I asked my employer to cancel my coverage due to lack of income. He says he can't do that until January 1. Why?
9. What is a “self-insured” plan?