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62 Iowa L. Rev. 57 (1976-1977)
Federal Preemption of State Insurance Regulation under ERISA

handle is hein.journals/ilr62 and id is 71 raw text is: FEDERAL PREEMPTION OF STATE INSURANCE REGULATION UNDER ERISA David J. Brummond* CONTENTS Introduction ......................................................................................... 59 I. The Preemption Problem: Section 514 of ERISA ....................... 64 II. Employee Benefit Plans and the Concept of Insurance ............... 67 A. Defining Insurance .............................................................. 68 B. Employee Benefit Plans and the Use of Insurance ............... 69 1. The Transfer Theory of Insurance and Insured Employee Benefits ......................................................... 70 a. Group Insurance ....................................................... 70 b. Prepaid Professional Service Plans ........................... 73 (1) Health Maintenance Organizations .................... 73 (2) Prepaid Legal Service Plans ................................ 75 2. The Pooling Theory of Insurance and Self-Insured Employee Benefit Plans ................................................ 76 III. Specific State Insurance Regulatory Laws and Practices Affecting Employee Benefit Plans .............................................. 79 A. State Employee Benefit Plan Legislation .............................. 80 B. Group Insurance Regulation .............................................. 81 C. Regulation of Blue Cross-Blue Shield Plans ......................... 84 D. State Regulation of Prepaid Professional Service Plans .......... 86 1. Regulation of Health Maintenance Organizations .......... 86 2. Regulation of Prepaid Legal Service Plans ..................... 87 3. Regulation of Dental Service Corporations .................... 88 E. State Regulation of Self-Insured Employee Benefit Plans ...... 89 1. Regulation of Self-Insured Plans as The Business of Insurance . ............................................................... 90 2. State Legislation Governing Self-Insured Employee Health Care Plans ..................... 91 3. Regulation of Other Aspects of Self-Insured Employee Benefit Arrangements .................................. 92 * B.A., Marquette University, 1972; J.D., University of Iowa, 1975. The author is currently employed as counsel to the National Association of Insurance Commissioners (NAIC). Sincere appreciation is expressed to the NAIC for its cooperation in the publication of this Article, as well as to Mr. Jon S. Hanson, Executive Secretary of the NAIC. whose comments and suggestions were particularly helpful in preparing the original manuscript for publication.