End employer-sponsored insurance for covered services

Year 4 · Employers; DOL; OPM (FEHB); state & local governmentsDiscuss this step

Every concrete action this step requires, who is responsible, and when it happens relative to enactment.

#	Action	Owner	When	Trade-off
4.2.1	Private employer plans terminate for UHP services; employers may offer supplementary benefits (cosmetic dental, premium eyewear, private rooms).	Employers	Day 1	Ending employer plans ends job lock but removes coverage many workers liked.
4.2.2	The Federal Employees Health Benefits program (FEHB, about 8M people) closes; OPM converts the employer contribution to pay or retirement contributions per maintenance-of-compensation rules.	OPM	Day 1	Closing FEHB treats federal workers like everyone else but ends a benefit used in federal recruitment.
4.2.3	State and local employee and retiree health plans close (teachers, police, firefighters); their premium spending becomes employer tax plus wage conversion.	States / localities	Day 1	Closing state and local plans saves governments money but breaks benefit promises bargained by public unions.
4.2.4	Retiree health benefits (pre-65 and Medicare supplements): employers with contractual obligations convert them to cash or pension increases at actuarial value; OPEB liabilities are largely extinguished.	Employers / unions	Year 4	Converting retiree benefits to cash honors obligations but gives retirees less certainty than a benefit.
4.2.5	Taft-Hartley multiemployer health funds: convert to supplementary benefits or close, with assets distributed to participants or pension funds by trustee vote.	Trustees / DOL	Year 4	Dissolving Taft-Hartley funds returns assets to members but ends union-run institutions.
4.2.6	Self-insured employer stop-loss and TPA contracts end.	Employers	Day 1	Ending stop-loss and TPA contracts saves overhead but ends businesses built around self-insurance.