On this episode of Comply on the Fly, host Karen B covers the core compliance considerations for employers moving from a fully insured to a self-funded health plan. While self-funding can offer greater cost control, it also brings added compliance responsibilities.
Karen walks through high-level obligations under ERISA, HIPAA, and the ACA—such as the need for updated plan documentation, direct handling of PHI, and obligations like PCORI fee payments and 1095-C reporting. She also touches on new transparency requirements, including prescription drug data reporting and gag clause attestations.