House Committee Advances Association Health Plans Act to Expand Group Coverage for Small Employers

Associations that meet the bill’s criteria can start being treated as an “employer” to sponsor one group health plan.

Small businesses and self-employed people could see new health plan options offered through associations they belong to, once plans are set up and marketed.

Association plan boards begin checking whether self-employed applicants meet the work and income requirements.

Self-employed people may need to provide documents showing they really work in the business (hours worked and income). Some applicants could be denied if they can’t prove it.

Ongoing monitoring of self-employed eligibility happens, and coverage can be cut off in a later plan year if someone no longer qualifies.

If your side business slows down or stops, you might have to switch coverage for the next year (for example, to a spouse’s plan, an individual plan, or another association plan).

Associations set base premiums and then adjust each employer member’s share up or down based on the employer’s risk profile, where state law allows it.

Some small businesses could see lower premiums, while others (with older or sicker workforces) could see higher costs or decide not to join.