Bill > SB608

This bill establishes a comprehensive framework for Association Health Plans (AHPs) in Pennsylvania, allowing groups of employers to join together to purchase health insurance with specific regulatory requirements. The bill defines key terms and creates detailed guidelines for how these associations can form and operate health insurance plans, including provisions that require associations to have been actively in existence for at least two years, have a formal organizational structure with regular meetings and voting privileges, and cannot discriminate based on health status. For associations with 51 or more employees, the health plans must be treated as large group market plans, comply with the Affordable Care Act's requirements, and provide coverage with an actuarial value of at least 60%. The bill mandates that the plan's governing board be primarily composed of employees (at least 75%), elected by participants, and requires insurers to set premiums based on collective group experience, average employee age, and prohibits premium variations based on gender. Importantly, the legislation aims to provide more flexible and potentially more affordable health insurance options for small businesses and sole proprietors by allowing them to band together to purchase group health coverage, while still maintaining consumer protections and standardized coverage requirements. The new regulations will take effect 60 days after the bill's passage.

Business and Industry

https://www.legis.state.pa.us/cfdocs/billinfo/bill_history.cfm?syear=2025&sind=0&body=S&type=B&bn=608