What should I do if I suspect insurance billing fraud?

Direct answer

No, because self-funded plans are primarily governed by the federal Employee Retirement Income Security Act (ERISA), which preempts most state insurance laws. It depends on whether the plan is fully self-funded or includes fully-insured components that may be subject to state oversight.

U.S. Department of Labor guidance documents regarding ERISA preemption of state mandates.


What this means for you

No, because self-funded plans are primarily governed by the federal Employee Retirement Income Security Act (ERISA), which preempts most state insurance laws. It depends on whether the plan is fully self-funded or includes fully-insured components that may be subject to state oversight.

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