What does Preamble of Association Health Plans Act do?

This bill aims to amend the Employee Retirement Income Security Act of 1974 The amendment clarifies the treatment of certain association health plans as employers

What does SHORT TITLE. of Association Health Plans Act do?

This bill is formally titled the Association Health Plans Act.

What does TREATMENT OF GROUP OR ASSOCIATION OF EMPLOYERS. of Association Health Plans Act do?

This section amends Section 3(5) of the Employee Retirement Income Security Act of 1974 (ERISA). It establishes criteria for a group or association of employers to be treated as an 'employer' solely for sponsoring a group health plan. To qualify, the group or association must meet several requirements, including having an employee welfare benefit plan covering at least 51 employees, being in existence for at least two years, and operating in good faith for purposes other than providing medical care. The group or association's governing board must consist of at least 75% employer members and be elected by participating employers. The group or association cannot be a health insurance issuer or controlled by one. Self-employed individuals are treated as both employers and employees for purposes of participating in such plans. The board of the group or association is responsible for determining and periodically monitoring whether individuals meet the requirements to be considered self-employed. Providing group health plan coverage by a group or association of employers does not establish an employer or joint employer relationship under federal or state law.

What does RULES APPLICABLE TO EMPLOYEE WELFARE BENEFIT PLANS ESTABLISHED of Association Health Plans Act do?

This section amends the Employee Retirement Income Security Act of 1974 (ERISA) to establish rules for employee welfare benefit plans maintained by groups or associations of employers. Plans may establish base premium rates using an actuarially sound, modified community rating methodology that pools all plan participant claims. Contribution rates for employer members can be actuarially adjusted above or below the base premium rate based on the specific risk profile of each employer. An 'employer member' is defined as an employer with at least one common law employee or a group of self-employed individuals with at least 20 members. If a group consists solely of self-employed individuals, all members are treated as a single risk pool, claims are pooled, and all participants are charged the same premium rate. The plan is prohibited from discriminating based on health status-related factors or denying coverage based on pre-existing conditions, consistent with existing laws. Eligibility rules cannot discriminate based on health status.

What does RULE OF CONSTRUCTION. of Association Health Plans Act do?

This Act does not exempt certain group health plans from ERISA requirements The Act clarifies treatment of association health plans as employers

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Association Health Plans Act

Last updated: 12/15/2025 · Introduced: 4/1/2025

Author: Tim Walberg (R-MI)

TL;DR (AI)

This bill allows groups or associations of employers to sponsor health plans and be treated as 'employers' under ERISA, provided they meet specific criteria like having at least 51 participants and operating in good faith.
Association health plans can set premium rates using a modified community rating methodology and adjust rates for individual employers based on their risk profile.
The bill clarifies that offering health coverage through these associations does not create employer or joint employer relationships and prohibits discrimination based on health status or pre-existing conditions.

119th Congressin committeeS. 1847(In Committee)Official page

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Other Sections

Includes provisions on preamble, short title., and 3 more.

5 sections

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