Expands who can band together to offer one employee health plan by allowing qualifying groups or associations of employers to be treated as a single employer under federal benefits law. It sets governance rules (including board oversight of who can join), allows self‑employed workers to participate if conditions are met, and clarifies that simply joining such a plan does not make members each other’s employer or joint‑employer.

It establishes premium rules: the plan’s base premium must use a modified community rating, while each employer’s contribution share can vary based on that employer’s risk. It also bars health‑status discrimination and pre‑existing condition exclusions. All such plans remain fully subject to existing federal consumer protections for group health plans.