Association Health Plans: Recent Developments, Key Issues, and Best Practices for ERISA Counsel
ERISA and ACA Contradictions, State Law Challenges, Small vs. Large Group Requirements and Exemptions
Course Details
- smart_display Format
On-Demand
- signal_cellular_alt Difficulty Level
- work Practice Area
ERISA
- event Date
Tuesday, September 24, 2019
- schedule Time
1:00 PM E.T.
- timer Program Length
90 minutes
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This 90-minute webinar is eligible in most states for 1.5 CLE credits.
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This CLE course will guide ERISA and benefits counsel on the rules and challenges associated with developing and implementing an association health plan (AHP) for small and large groups. The panel will discuss recent regulatory and judicial developments, ACA requirements, and best practices for ERISA compliance.
A 2018 Final Rule by the Department of Labor created a new pathway for associations to sponsor health plans for their members. Under that rule, small businesses had additional flexibility to band together to obtain coverage in the large group insurance market with fewer coverage requirements.
Historically, multiple employers have been treated as a single "employer" under ERISA if they are members of a bona fide group or association of employers so long as there is a "commonality of interest" among them. Recently, in response to lawsuits filed in 12 jurisdictions, including California and New York, the district court invalidated portions of the AHP rules, leaving existing new rule AHPs in limbo and preventing the formation of new AHPs.
AHPs are subject to state laws and regulations governing multiple employer welfare arrangements (MEWAs) and other federal mandates such as coverage of mental health benefits, no lifetime or annual limits on specific benefits, and nondiscrimination provisions. ERISA and benefits counsel must understand how these complex regulatory layers apply to these new AHPs, and whether other options are available under DOLs advisory opinion guidance.
Listen as our panel discusses recent developments for AHPs, including the state legal challenge and best practices for AHPs to ensure compliance with federal and state law.
- Overview of the district court ruling, and the DOLs response
- Other options for association plans
- MEWA regulations and other state challenges
- Best practices for AHPs to ensure compliance with federal and state law
The panel will review these and other high priority issues:
- Identifying areas of concern following the district court’s ruling on the DOL final regulations for AHPs
- Determining "commonality of interest" in qualifying as bona fide association under DOLs prior guidance
- Understanding ACA requirements and exemptions applicable to small employers and AHPs
- Recognizing state law challenges and MEWA regulations impacting AHPs
- Determining the applicability of new provisions to current plans and best practices to ensure compliance
