Pennsylvania Insurance Commissioner outlines position on implementing association health plans rule

Pennsylvania Insurance Commissioner Jessica Altman recently sent a letter to the U.S. departments of Labor and Health and Human Services describing the Insurance Department’s position on the implementation of a federal rule that aims to expand association health plans (AHP).

The AHP policy aims to expand employers’ ability to join an employer group or association to offer employer-sponsored health care coverage.

In the letter, Altman outlined the department’s standards for AHPs. The standards require an association to have been active for at least two years to offer a plan and specify that businesses with just one employee are not eligible for AHPs. The standards also require AHPs organized in other jurisdictions to adhere to Pennsylvania’s regulations.

AHP plans would be offered outside of the Affordable Care Act (ACA) markets. They may provide less expensive coverage options and may not offer the full patient protections and benefits guaranteed under the ACA.

The AHP rule will be implemented on a rolling basis between Sept. 1 and April 1, 2019. Timing depends on whether the plan is existing or new and whether the plan will be self-funded or fully insured.

The Commonwealth of Pennsylvania submitted comments in March in response to the proposed rule. In the comments, Altman raised concerns about the fact that AHPs would not have to meet coverage requirements under the ACA and warned that the policy could destabilize the market.

“I remain concerned that this rule will allow for substandard coverage that will limit consumers’ access to comprehensive health care, and I am committed to ensuring that our laws will continue to provide necessary protections to consumers,” Altman wrote.