Association Health Plans | Everything You Need to Know About AHPs

As the future of healthcare in the U.S. remains uncertain and, at times, confusing, we wanted to take a moment to share a potentially game-changing provision in a Presidential Executive Order that came late last year regarding Trade Associations and Small Businesses across the country.

Association Health Plans Executive Order

The provision relates to the expansion of Association Health Plans (AHPs) and, given that Spring is a facilitator for one of the only two State-Approved Healthcare Cooperatives in Massachusetts, we are tentatively excited to see the administration loosening regulations for AHPs and recognizing the benefits that buying together offers to small businesses and employers. By joining together to purchase coverage for their employees, these businesses can dramatically cut costs while both better serving their employees and reinvesting in their own economic growth.

Small businesses specifically benefit from the freedom to join together across state lines and, in some cases, pool their risk by forming an AHP, because it opens up the freedom to craft coverage that better suits the needs of the companies and their employees. Without this option, these smaller employers often are forced to purchase overpriced plans that are either excessive or ill-suited for their workforce, wasting resources and straining their already tight finances.

This small provision in the executive order – and the new regulations that will soon follow – may well enable small businesses much greater control over building their benefits packages, but constructing a stable long-term Association Health Plan remains complex and challenging. Spring Consulting Group has developed best-in-class solutions for AHPs and their members, and recognizes the key role benefits play in helping businesses attract and retain the best possible workers.

The Executive Order was signed in October of 2017 and then went to the Department of Labor (DOL) and the Centers for Medicare and Medicaid Services (CMS) for consideration. As of January 4th, 2018, the proposed regulations are still on the table, and we are in a comment period until March 6th.

In what ways would the proposed regulation expand the market for Association Health Plans?

  1. Association Health PlansIt would allow a reclassification for AHPs, eliminating some prerequisites that previously existed, such as the provision of mental health services. This means more groups would qualify as AHPs.
  2. It would allow individuals to buy an AHP, something which wasn’t permitted previously.
  3. It would allow small business to band together for the purpose of affordable group healthcare, whereas before an AHP could only be formed as a sort of spin-off of a group that already existed for some other reason not pertaining to health plans.
  4. It would allow AHPs to be sold across state lines.

These are the most notable ways this could be a positive change for US healthcare, and one that opens many doors that had previously been closed. Now more than ever, it is critical that the accessibility of affordable yet effective health plans increases.

More About Association Health Plans

This video below spotlights what the AHP regulation means for businesses and existing associations. We provide an overview of AHPs, the current laws that pertain to them and the ways in which this could be a game-changer for your business or association.

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Managing Medical Stop Loss in a Captive (Presentation)

Spring Senior Partner John Cassell recently organized and participated in a session at the Captive Insurance Companies Association (CICA) annual conference titled Developing the Operational Strategy of Managing Medical Stop Loss in Your Captive. Cassell was joined by co-presenters Stephen Hannabury, President of Educators Health Insurance Exchange of New England and Jesse Crary, an attorney from Primmer Piper Eggleston & Cramer PC.

See also: Spring’s Guide to Medical Stop Loss in a Captive (White Paper)

The CICA session focused on Ed Health, a medical stop loss group captive consisting of 11 Boston-area colleges that Spring assisted in the development of. The slidedeck below, which was used in the presentation, details Ed Health’s success to date and lessons learned through the development and ongoing management of a medical stop loss group captive.

We hope you find this deck helpful and please don’t hesitate to reach out to John using the form below with any questions about group captives and/or medical stop loss in captives.

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Webcast: A Look at How and Why Colleges are Funding Health Insurance Using a Medical Stop-Loss Captive

medical stop-loss captive

Recently, Spring Senior Partner John Cassell presented a session on colleges funding health insurance using a medical stop-loss captive. The session covers how to create a medical stop-loss captive, the economies and efficiencies that can be achieved and why colleges and universities should have this on their radar.

In this webcast, John is joined by Spring Partner Teri Weber and Tracy Hassett who is Vice President, Human Resources at Worcester Polytechnic Institute in Worcester, Massachusetts.

Worcester Polytechnic Institute is a member of Ed Health, a successful example of a group of colleges and universities that banded together to form a captive to fund their medical stop-loss coverage. Ed Health has completed its first year and is already generating significant savings for its expanding base of members.

Photo by 401(K) 2013

White Paper: Creating Cost-Effective Employee Benefit Programs Through Employer Associations

Employer Associations White PaperFor employers, providing employee benefits has always been accepted as an essential way of attracting and retaining employees.  At the same time, funding employee benefits has proved to be a high-risk complex task, fraught with unpredictable cost inflation, frequent changes in legislation and now the emerging confusion of healthcare reform.

Individual organizations have to maintain full knowledge of the rapidly evolving employee benefits market and unless they have thousands of employees, they cannot leverage the economies of scale to manage costs and keep their benefits under control.

Associations are able to provide a variety of valuable services to their members from representation to sharing of best practices and innovation. Many associations also look to ways in which they can use the purchasing power of their group to provide relevant goods and services at lower cost. This joint purchasing is often one of the most valuable benefits the association provides. At a time when costs are under increasing scrutiny, savings made via these arrangements are seen as a useful way to offset association fees.

In our latest free Spring white paper, titled “Employer Associations: Leveraging Buying Power to Create Cost-Effective Employee Benefit Programs,” our Senior Partner John Cassell takes a look at the basics of employer associations and offers up a few case studies based on some of his past experience with them.

Please fill out the form below to download your free copy of this informative white paper:

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