Private Health Insurance: Unauthorized or Bogus Entities Have Exploited Employers and Individuals Seeking Affordable Coverage Page: 7 of 22
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states' authority to regulate insurers and insurance policies). Therefore,
under ERISA, self-funded employer group health plans generally are not
subject to the state oversight that applies to insurance companies and
health insurance policies. The federal and state governments coordinate
their regulation of MEWAs, with states having the primary responsibility to
regulate the fiscal soundness of MEWAs and to license their operators, and
DOL enforcing ERISA's requirements.
DOL and States
Identified 144 Unique
Operating from 2000
through 2002 That
Left More Than
$250 Million in Unpaid
DOL and the states identified 144 unauthorized entities from 2000 through
2002. This likely represents the minimum number of unauthorized entities
operating during this period because some states did not report on entities
that they were still investigating. The number of unauthorized entities
newly identified by DOL and the states each year almost doubled from
2000, when 31 were newly identified, through 2002, when 60 were newly
DOL and the states found that every state had at least 5 entities operating
in it. Specifically, the number of entities per state ranged from 5 in
Delaware and Vermont to 31 in Texas. (See fig. 1.) Many entities marketed
their products in more than one state, and some operated under more than
one name or with more than one affiliated entity. These entities were
concentrated in certain states and regions. Seven states had 25 or more
entities that operated during this period; 5 of these states were located in
the South. In addition to the 31 entities in Texas, 30 were in Florida, 29
each in Illinois and North Carolina, 28 in New Jersey, 27 in Alabama, and
25 in Georgia.
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United States. General Accounting Office. Private Health Insurance: Unauthorized or Bogus Entities Have Exploited Employers and Individuals Seeking Affordable Coverage, text, March 3, 2004; Washington D.C.. (digital.library.unt.edu/ark:/67531/metadc294100/m1/7/: accessed January 22, 2019), University of North Texas Libraries, Digital Library, digital.library.unt.edu; crediting UNT Libraries Government Documents Department.