Bill > HR2528

This bill amends the Employee Retirement Income Security Act (ERISA) to expand the definition of an "employer" for the purpose of establishing association health plans (AHPs), which are group health insurance plans that allow small businesses and self-employed individuals to join together to purchase health coverage. The bill establishes specific criteria for how these associations can be formed, including requirements that the association: be in existence for at least two years, have a formal governing board with elected members, serve at least 51 employees, be formed for purposes beyond healthcare, not discriminate based on health status, and not be controlled by a health insurance company. Self-employed individuals can now be considered both employers and employees in these associations, provided they meet certain conditions like having a bona fide business ownership, working at least 10 hours per week in their business, and having no common law employees. The bill also allows these associations to establish premium rates using a modified community rating methodology that considers the specific risk profile of each employer member, while maintaining protections against discrimination and pre-existing condition exclusions. Importantly, the bill does not exempt these association health plans from existing healthcare coverage requirements and regulations, ensuring that they still must comply with established consumer protection standards.

Education

https://www.congress.gov/bill/119th-congress/house-bill/2528/all-info