Opinion ID: 223249
Heading Depth: 4
Heading Rank: 3

Heading: Eligible Employer-Sponsored Plans

Text: Individuals may also satisfy the mandate by purchasing coverage through any eligible employer-sponsored plan. Id. § 5000A(f)(1)(B). An eligible employer-sponsored plan is a group health plan or group health insurance coverage offered by an employer to the employee, which is defined broadly as: (1) a governmental plan established by the federal, state, or local government for its employees; (2) any other plan or coverage offered in the small or large group market within a State; or (3) a grandfathered health plan offered in a group market. Id. § 5000A(f)(2). Health plans of large employers satisfy the individual mandate whatever the nature of the benefits offered to the employee. [48] Whether a self-insured health plan of large employers satisfies the mandate is another story. [49] The mandate's § 5000A(f)(2) refers to plans in the small or large group market.  Id. § 5000A(f)(2)(emphasis added). A self-insured health plan, by definition, is not sold or offered in a market. It is thus not clear whether large employers' self-insured plans will constitute eligible employer-sponsored plans in § 5000A(f)(2) and thereby satisfy the mandate. It may be that HHS will later recognize self-insured plans under the other coverage or grandfathered plan categories in the mandate's § 5000A(f)(2).