Dive Brief:
- The U.S. Supreme Court has agreed to hear a case that would determine whether or not self-funded insurer Liberty Mutual has to provide the state of Vermont with healthcare data for the state's databases.
- In Gobeille v. Liberty Mutual Insurance Co., the state of Vermont is arguing that it needs the data to improve the cost and effectiveness of healthcare in the state.
- Liberty says it should be exempt from having to provide the data under the federal Employee Retirement Income Security Act (ERISA), which sets uniform national standards for employee benefit plans.
Dive Insight:
This is an important case that could result in a number of burdensome state reporting requirements—beyond ERISA itself—for plan administrators. (ERISA preempts "any and all State laws insofar as they... relate to any employee benefit plan," but includes a series of mandatory reporting requirements on covered plans.) A ruling could potentially impact reporting requirements in at least sixteen states—possibly more, if others that are considering similar legislation move forward.
In an earlier decision, the 2nd US Circuit Court of Appeals ruled in favor of Liberty, saying that ERISA outweighed state law. Last December, Supreme Court justices held a closed-door conference at which they discussed the case, but decided to ask the federal government for input as to whether or not they should officially hear it.
As of now, the circuit court's decision is only binding in Vermont, Connecticut and New York, but the Supreme Court's decision could eventually affect self-funded insurers in other states. Had the Court declined to hear the case, the circut court's decision would have stood, opening the door for other self-funded insurers to challenge state requests for data sharing.
Liberty provides benefits for employees, retirees and family members; Blue Cross Blue Shield of Massachusetts is the adminstrator of the plan.