As we enter 2019, there is not yet an association group plan nor any customized health plans that the AIA Trust can offer to AIA members—but the AIA Trust is continuing to monitor the situation in the event that changes.
The continuing Affordable Care Act (ACA) still defines only two ways in which someone can purchase private insurance: through their employer or as an individual. Currently membership associations cannot band together and purchase health insurance on behalf of their members, and until that changes, there are no immediate plans with association group pricing that the AIA Trust (or anyone) can offer to individual members.
The Trustees are committed to finding a healthcare solution as soon as possible. We are working in conjunction with our independent consultant, the AIA Small Firm Exchange, and an insurance agency to explore the potential new options that are permissible for association plans under the new DOL guidance.
The Department of Labor (DOL) announced regulations on June 19, 2018 that expand the definition of Association Health Plans (AHPs). This expansion applies to firms and the self-employed (working owners). However, a fully insured AHP option is dependent on the insurance companies obtaining approvals from the various states and offering such products in the marketplace. The DOL guidance clearly reaffirms the regulatory oversight authority of each state and the approval timelines vary greatly among the states.
Several state regulators view AHPs as a threat to the ACA provisions and to the overall stability of the market and have indicated their opposition to permitting AHPs in their respective states. There is also pending litigation against the DOL by some of these same states, thus making a nationwide solution less likely at this juncture.
It appears that many health insurance carriers are taking a “wait-and-see” approach regarding potential AHP offerings and therefore, there are limited options at present to pursue a fully-insured plan. However, United HealthCare has expressed an interest in offering AHPs and our team has ongoing discussions with their representatives. The AIA Trust will continue to have discussions with brokers and carriers that may be willing to offer an AHP to AIA members.
The situation was recently more obscured when on December 14, 2018, a federal judge in Texas ruled that the ACA is unconstitutional since Congress had eliminated the penalty for those who did not have health insurance. Appeals will be made to the Fifth U.S. Circuit court of Appeals and potentially to the Supreme Court, but it may take some time before a final determination is made. The judge issued a stay in the case, so the law will remain in effect during the appeals process.
As we have updates on this topic, we will share them on our AIA Trust website: https://www.theaiatrust.com/healthcare-coverage. We also regularly update our page of healthcare resources found here: https://www.theaiatrust.com/healthcare-coverage/national-healthcare-reform/. In addition, you can sign up for the quarterly AIA Trust newsletter, Managing Your Risks, here: https://www.theaiatrust.com/news/ which will continue to publish healthcare coverage updates. And follow the AIA Trust on social media for the latest updates.
The AIA Trust has identified Simply Insured, which is a service aimed at small firms of 2 to 50 employees. Employers may investigate and analyze health care plans and expenses including deductibles, out-of-pocket, premiums, prescription drugs, etc. While Simply Insured is licensed in 50 states, they do not quote insurance in MN, ND, SD, VT, HI, DC. Note that Blue Cross/Blue Shield does not participate in certain states and should be contacted directly if not found on their website. To find out more, visit http://info.simplyinsured.com/hbi/.
Note that the next open enrollment date for ACA health insurance is November 1 through December 15, 2019 and the website is https://www.healthcare.gov/.