It’s a Good Time to Revisit ERISA Compliance Responsibilities Considerations for Self‑Insured and Level‑Funded Group Health Plans By GRANT P.H. SHUMAN, Attorney, Bowles Rice LLP Recent trends indicate that more employers will switch from a fully insured group health plan to a self-insured or level-funded group health arrangement over the next few years. Indeed, McKinsey & Company’s 2024 Employer Health Benefits Survey projects that as many as 12 million employees may leave fully insured group health plans by 2030 due to rising costs under the fixed-premium insured model. As a result, employers moving to a self-insured or level-funded group health platform may need to complete additional tasks to ensure compliance with the Employee Retirement Income Security Act of 1974 (ERISA). In the case of fully insured group health plans, an employer may be accustomed to the insurer providing some or much of the information required by ERISA for compliance purposes. Depending on its construction, a self-funded or level-funded plan may need to take a more active role in claims and appeals processes, required plan documents, and compliance with the Health Insurance Portability and Accountability Act (HIPAA), among others. This article will highlight one such responsibility that can slip through the cracks of a self-insured or level-funded group health plan’s compliance procedures: the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). The Employee Benefits Security Administration (EBSA) — the U.S. Department of Labor (DOL) agency that ensures the integrity of private-sector employee benefit plans — issued a news release on Jan. 15, 2026, which once again highlighted MHPAEA as a nationwide focus of EBSA’s investigative efforts. In the context of fully insured health plans, the insurance carrier is responsible for compliance with Mental Health Parity requirements. However, self-insured or level-funded plans with 50 or more employees are also required to satisfy MHPAEA’s mandate. Indeed, MHPAEA requires employers who maintain self-insured or level-funded group health plans to have certain documentation in place or face civil penalties under federal law. As a result, MHPAEA is a timely example of a potential ERISA compliance failure that may catch the attention of federal regulators. 10 WEST VIRGINIA BANKER
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