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This bill would allow small businesses to create association health plans (AHPs) so they can join together to increase their bargaining power in the health insurance marketplace and use that leverage to offer their employees more affordable healthcare coverage. AHPs could include businesses from different states, and they would be exempted from state-mandated benefit laws.

AHPs would need to be certified by the Dept. of Labor, which would create class certification systems for fully-insured association plans and for self-insured association plans. AHPs that also offer benefits that aren’t health insurance would be required to have reserves and stop-loss insurance to cover those benefits in addition to making contributions to a fund that would be used to pay for stop-loss insurance for AHPs that may not be able to pay out their claims. If an AHP doesn’t meet these requirements it would be subject to termination.

States would be able to tax contributions to AHPs under certain circumstances. However, states would be prohibited from barring health insurers from offering insurance through a certified AHP, or from blocking insurers from offering insurance of the same policy type to other employees that are eligible for coverage under AHPs.

Under current law, small businesses are prohibited from forming interstate associations to buy health insurance for their employees, which disadvantages them relative to large businesses and labor organizations because of their size and economies of scale.

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Should Small Businesses be Allowed to Form Associations for Buying Their Employees Health Insurance?