Mandates and Regulations applying to Association Health Plans

By the Legislative Affairs Team, Zelis Healthcare

On June 21, the Department of Labor (DOL) published a final rule on Association Health Plans (AHPs). The rule adopted several changes to current DOL guidance that would make it easier for health plans to be created by diverse combinations of employers.

An important take away is that the rule did not deregulate AHPs; it did not change any of the underlying provisions in ERISA, ACA or state laws that would apply to AHPs via requirements applying to group health plans or the small group and individual health insurance markets. The final rule did not exempt AHPs from state regulatory authority, although, notably, DOL hinted in both the proposed and final rules that it may do so in the future.

The table below compares AHPs with other health plan categories in terms of some of the existing mandates that AHPs would fall under, according to the final rule. For more detail on the mandates and regulations that would apply to AHPs, see Zelis’ article on the proposed AHP rule.

 

2018 AHP Chart