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F:\P11\NHI\TRICOMM\AAHCA09_001.

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22
1 employer health care markets. Such study shall ex-
2 amine the following:
3 (A) The types of employers by key charac-
4 teristics, including size, that purchase insured
5 products versus those that self-insure.
6 (B) The similarities and differences be-
7 tween typical insured and self-insured health
8 plans.
9 (C) The financial solvency and capital re-
10 serve levels of employers that self-insure by em-
11 ployer size.
12 (D) The risk of self-insured employers not
13 being able to pay obligations or otherwise be-
14 coming financially insolvent.
15 (E) The extent to which rating rules are
16 likely to cause adverse selection in the large
17 group market or to encourage small and mid
18 size employers to self-insure
19 (2) REPORTS.—Not later than 18 months after
20 the date of the enactment of this Act, the Commis-
21 sioner shall submit to Congress and the applicable
22 agencies a report on the study conducted under
23 paragraph (1). Such report shall include any rec-
24 ommendations the Commissioner deems appropriate
25 to ensure that the law does not provide incentives

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