Fully insured plan

A fully insured plan is health coverage your employer buys from an insurer. Your employer pays premiums, and the insurer pays the claims. The other common type is a self-funded plan, where your employer pays claims with its own money.

The difference matters when you have a problem. State insurance laws generally apply to fully insured plans. That can include state rules on what plans must cover and how an outside review of a denial works. Self-funded plans generally don't have to follow those state laws, though federal rules still apply.

If you're not sure which type you have, ask your employer's benefits office. Then see how to appeal a health insurance denial for your next steps.