Sec. 1254. STUDY OF LARGE GROUP MARKET

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## SEC. 1254 STUDY OF LARGE GROUP MARKET ###

(a)In General The Secretary of Health and Human Services shall conduct a study of the fully-insured and self-insured group health plan markets to— ####

(1)compare the characteristics of employers (including industry, size, and other characteristics as determined appropriate by the Secretary), health plan benefits, financial solvency, capital reserve levels, and the risks of becoming insolvent; and ####

(2)determine the extent to which new insurance market reforms are likely to cause adverse selection in the large group market or to encourage small and midsize employers to self-insure. ###

(b)Collection of Information In conducting the study under subsection (a), the Secretary, in coordination with the Secretary of Labor, shall collect information and analyze— ####

(1)the extent to which self-insured group health plans can offer less costly coverage and, if so, whether lower costs are due to more efficient plan administration and lower overhead or to the denial of claims and the offering very limited benefit packages; ####

(2)claim denial rates, plan benefit fluctuations (to evaluate the extent that plans scale back health benefits during economic downturns), and the impact of the limited recourse options on consumers; and ####

(3)any potential conflict of interest as it relates to the health care needs of self-insured enrollees and self-insured employer's financial contribution or profit margin, and the impact of such conflict on administration of the health plan. ###

(c)Report Not later than 1 year after the date of enactment of this Act, the Secretary shall submit to the appropriate committees of Congress a report concerning the results of the study conducted under subsection (a).