Health insurance; association health plans. (SB235)

Introduced By

Sen. George Barker (D-Alexandria) with support from co-patron Sen. Siobhan Dunnavant (R-Henrico)

Description

Health insurance; association health plans. Provides that for policies of group accident and sickness insurance issued to an association, members of such an association may include (i) a self-employed individual and (ii) an employer member with at least one employee that is domiciled in the Commonwealth. The bill provides that for such policies issued to an association that covers at least 51 members and employees of employer members of such association on the first day of the plan year the policies shall be considered a large group market plan and are required to meet various provisions in the bill. The bill provides that to determine the size of an association all of the members and employees of employer members are aggregated and treated as employed by a single employer. The bill requires an insurer issuing a policy to an association to (a) treat all of the members and employees of employer members who are enrolled in coverage under the policy as a single risk pool; (b) set premiums based on the collective group experience of the members and employees of employer members who are enrolled in coverage under the policy; (c) vary premiums by age, except that the rate shall not vary by more than five to one for adults; (d) not vary premiums based on gender; and (e) not establish discriminatory rules based on the health status of an employer member, an individual employee of an employer member, or a self-employed individual for eligibility or contribution. The bill requires the Commissioner of Insurance to initiate proceedings to apply to the U.S. Secretary of Health and Human Services for a state innovation waiver under the federal Patient Protection and Affordable Care Act, P.L. 111-148, to implement the provisions of the bill and within 180 days of a certain judicial order to submit the waiver request to implement the provisions of the bill regarding association health plans. This bill is identical to HB 795. Read the Bill »

Status

03/07/2020: Passed the General Assembly

History