Association Health Plans Act

This bill makes it easier for small employers and the self‑employed to band together to buy health coverage as one large group. A group or association can count all member employees together (needs at least 51 total), can span different industries, must have existed for at least two years, and must be run by a board mostly made up of employer members. It can’t be an insurance company, can’t limit membership based on health, and may only cover employees of member employers. All members are treated as part of one plan. Offering coverage this way does not make the group a “joint employer” under other laws. These plans still must follow existing federal health plan rules, including protections under ERISA and the Public Health Service Act.

Self‑employed people without employees can join too if they own a real business, earn wages or self‑employment income from it, and work at least 10 hours a week (or 40 hours a month). The plan’s board must check eligibility and can end coverage if requirements aren’t met, but coverage can resume if proof is provided later. Plans cannot deny coverage for pre‑existing conditions or charge more or set rules based on someone’s health. For pricing, plans may set base premiums by pooling all claims, then adjust how much each employer pays based on that employer’s risk. If a plan is made up only of self‑employed members, everyone is in one risk pool and pays the same rate.

• Who is affected: Small employers and self‑employed individuals who join an association health plan; employees of member employers.
• What changes: Lets associations act like a single large employer for health coverage, sets governance and eligibility rules, and allows pooled pricing with guardrails.
• Key protections: No health‑status discrimination; no pre‑existing condition denials; ongoing compliance with federal health plan requirements.