Large employers are continuing to make more use ofself-insurance programs, but the small employers that still offerhealth benefits are making less use of self-insurance.

Paul Fronstin, an analyst at the Employee Benefit Research Institute (EBRI), haspublished data supporting that conclusion in a report based onfederal government survey data.

Fronstin found that the percentage of all U.S. private-sectorgroup plan enrollees who are in self-insured plans increased to58.5% in 2011, from 57.5% in 2010.

The percentage has increased every year since 2006 and is upfrom a modern low of 40.9% recorded in 1998.

But Fronstin found a size-based split in use of self-insurance:The percentage has increased to 68.5%, from 67.5%, for employees ofemployers with 50 or more employees, and it has fallen to 10.8%,from 12.5%, for employees of employers with fewer than 50employees.

An employer with a self-insured or self-funded health plan hasthe plan itself assume most or all of the claims risk. The employercan hire an ordinary retail health insurer, or an independentthird-party administrator, to run the plan, and an employer can buystop-loss coverage, or health plan insurance, to cover claims thatexceed pre-set limits.

States have the legal authority to impose coverage requirements,or mandates, on small employers' self-insured plans but not onlarge employers' self-insured plans.

Analysts at EBRI lookedfor evidence that small employers were more likely to self-insurein states with large numbers of mandates, but it found no clearcorrelation between the number of mandates a state imposes and thepercentage of employers that self-insure, Fronstin said.

EBRI analysts would like to look harder at the possibility thata correlation exists by, for example, using data that shows howcostly a state's mandates are, as well as how many mandates thestate imposes, or data showing how much state health insurance lawsand regulations other than benefits mandates cost, Fronstinsaid.

This article was originally posted at BenefitsPro.com, a sister site of CreditUnion Times.