Outside the Box: This little-known legal risk could force big changes to our dysfunctional health-care system

Erisa — the Employee Retirement Income Security Act — has been around since the Ford administration. Most people know the law in relation to retirement benefits, but it’s emerging as an unexpected yet high-potential opportunity to drive systemic change across the dysfunctional U.S. health-care system.

The law sets fiduciary standards for using funds for self-insured health plans, which is how more than 100 million Americans receive health benefits. Health plans for companies with more than 250 employees are self-funded because they are generally less costly to administer. As a result, just over $1 trillion in annual health-care spending is under Erisa plans or out-of-pocket by Erisa plan participants, and the amount spent on Erisa health plans is roughly double the amount spent on Erisa retirement plans.

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