Why do some employers decide to self-insure for their health insurance plans while others do not? Are they influenced by the fact that state laws prohibit managed care plans from restricting the employee's choice of provider? What effect would congressional or court-ordered changes to the federal law ERISA have on the future of employer health insurance?

In a new study sponsored by the Health Care Financing and Organization Program of the Robert Wood Johnson Foundation, Gail Jensen and Michael Morrisey use data from the 1990s on employer-sponsored health insurance plans and changes in state health insurance laws to study the effects of state regulation and other market forces on employers' decisions to self-insure. When an employer decides to self-insure for its group health insurance, it foregoes participating in an insurance pool organized through a health insurance company and instead accepts the responsibility of managing its own risks. Under ERISA, self-insured plans are exempt from most state insurance requirements and state premium taxes. The dramatic increase in self-insurance in the early 1990s coincided with the growth of a variety of managed care plans, which varied widely throughout the states

Has the proliferation of state laws targeted at managed care plans motivated employers to self-insure? At this event, Gail Jensen will present findings about state managed care regulation and the expansion of self-insurance among employers. Participants will also discuss the policy implications of these findings.