Group health benefit plans; bona fide associations, benefits consortium. (SB861)

Introduced By

Sen. Monty Mason (D-Williamsburg) with support from co-patrons Sen. Siobhan Dunnavant (R-Henrico), Sen. Joe Morrissey (D-Richmond), and Sen. David Suetterlein (R-Salem)


Passed Committee
Passed House
Passed Senate
Signed by Governor
Became Law


Group health benefit plans; bona fide associations; benefits consortium. Provides that certain trusts constitute a benefits consortium and are authorized to sell health benefits plans to members of a sponsoring association that (i) has been formed and maintained in good faith for purposes other than obtaining or providing health benefits; (ii) does not condition membership in the sponsoring association on any factor relating to the health status of an individual, including an employee of a member of the sponsoring association or a dependent of such an employee; (iii) makes any health benefit plan available to all members regardless of any factor relating to the health status of such members or individuals eligible for coverage through a member; (iv) does not make any health benefit plan available to any person who is not a member of the association; (v) makes available health plans or health benefit plans that meet requirements provided for in the bill; (vi) operates as a nonprofit entity under § 501(c)(5) or 501(c)(6) of the Internal Revenue Code; and (vii) has been in active existence for at least five years. The bill replaces references to "bona fide association," as used in provisions applicable to health care plans in the small employer market, with the term "sponsoring association." The bill requires any health benefit plan issued by a self-funded multiple employer welfare arrangement (MEWA) that covers one or more employees of one or more small employers to (a) provide essential health benefits and cost-sharing requirements; (b) offer a minimum level of coverage designed to provide benefits that are actuarially equivalent to 60 percent of the full actuarial value of the benefits provided under the plan; (c) not limit or exclude coverage for an individual by imposing a preexisting condition exclusion on that individual; (d) be prohibited from establishing discriminatory rules based on health status related to eligibility or premium or contribution requirements as imposed on health carriers; (e) meet the renewability standards set forth for health insurance issuers; (f) establish base rates formed on an actuarially sound, modified community rating methodology that considers the pooling of all participant claims; and (g) utilize each employer member's specific risk profile to determine premiums by actuarially adjusting above or below established base rates, and utilize either pooling or reinsurance of individual large claimants to reduce the adverse impact on any specific employer member's premiums. The bill prohibits a self-funded MEWA from issuing health benefit plans in the Commonwealth until it has obtained a license pursuant to regulations promulgated by the Commission. The bill authorizes the Commission to adopt regulations applicable to self-funded MEWAs, including regulations addressing financial condition, solvency requirements, and the exclusion of self-funded MEWAs from the Virginia Life, Accident and Sickness Insurance Guaranty Association. Read the Bill »


03/07/2020: Passed the General Assembly


01/08/2020Prefiled and ordered printed; offered 01/08/20 20103816D
01/08/2020Referred to Committee on Commerce and Labor
01/15/2020Assigned C&L sub: Health Insurance
01/16/2020Impact statement from SCC (SB861)
01/20/2020Reported from Commerce and Labor with amendments (14-Y 0-N 1-A) (see vote tally)
01/22/2020Constitutional reading dispensed (40-Y 0-N) (see vote tally)
01/23/2020Read second time
01/23/2020Reading of amendments waived
01/23/2020Committee amendments agreed to
01/23/2020Engrossed by Senate as amended SB861E
01/23/2020Printed as engrossed 20103816D-E
01/24/2020Read third time and passed Senate (35-Y 2-N) (see vote tally)
02/12/2020Impact statement from SCC (SB861E)
02/13/2020Placed on Calendar
02/13/2020Read first time
02/13/2020Referred to Committee on Labor and Commerce
02/14/2020Assigned L & C sub: Subcommittee #2
02/18/2020House subcommittee amendments and substitutes offered
02/18/2020Subcommittee recommends reporting with substitute (8-Y 0-N)
02/20/2020House committee, floor amendments and substitutes offered
02/24/2020Impact statement from SCC (SB861E)
02/25/2020Reported from Labor and Commerce with substitute (8-Y 7-N) (see vote tally)
02/25/2020Committee substitute printed 20108216D-H1
02/27/2020Read second time
02/28/2020Passed by for the day
03/02/2020Impact statement from SCC (SB861H1)
03/02/2020Read third time
03/02/2020Committee substitute agreed to 20108216D-H1
03/02/2020Engrossed by House - committee substitute SB861H1
03/02/2020Passed House with substitute (57-Y 41-N)
03/02/2020VOTE: Passage (57-Y 41-N) (see vote tally)
03/03/2020House substitute agreed to by Senate (40-Y 0-N) (see vote tally)
03/03/2020Title replaced 20108216D-H1
03/06/2020Bill text as passed Senate and House (SB861ER)
03/07/2020Signed by President
03/07/2020Signed by Speaker
03/09/2020Impact statement from SCC (SB861ER)
03/12/2020Enrolled Bill Communicated to Governor on March 12, 2020
03/12/2020G Governor's Action Deadline 11:59 p.m., April 11, 2020
04/11/2020Governor's recommendation received by Senate
04/22/2020Senate rejected Governor's recommendation (7-Y 33-N) (see vote tally)
04/22/2020Communicated to Governor
04/22/2020G Governor's Action Deadline 11:59 p.m., May 22, 2020