How Do Association Health Plans Work?
Association Health Plans (AHPs) have been around for decades, but since the Affordable Care Act (ACA) became law in 2010, AHPs have changed. In fact, AHPs are no longer available in California. However, these plans are available in Nevada and more than a dozen other states.
At its core, an Association Health Plan is a type of group health insurance that allows smaller companies (as well as freelancers and the self-employed, in some situations) to access the health insurance savings associated with large group health coverage. As an insurance industry insider, you know “Large Group” health insurance means a group of 51+ or 101+ eligible employees. In California, it’s 101+; in Nevada, Large Group is 51+ eligible employees.
California first sought to eliminate AHPs through Senate Bill (SB) 1375. It prevents small businesses and self-employed individuals without employees from enrolling in a group health plan, while prohibiting employer group plans from being issued, marketed, or sold to a sole proprietorship or partnership, directly or indirectly, through any arrangement, including an association. The law affected plan years on or after January 1, 2019.
Beginning July 1, 2020, all AHPs had to cease renewing existing large group contracts for small employers. As a result, small employers in California are unable to purchase large group coverage starting July 1, 2021.
What Association Health Plans Are Available?
Word & Brown offers AHP coverage to small businesses in Nevada through Prominence Health Plan. The roster of available plans was updated in 2021 and it now includes:
- Six, affordable health plan options, including HSA-qualified coverage
- Multiple coinsurance options: 10%, 20%, and 30%
- Enhanced benefits with lower out-of-pocket costs and copays for emergency room and diagnostic services
- Statewide HMO open access with no referrals + Cigna PPO national network access
Coverage is available in seven areas of Nevada: Carson City, Clark County, Douglas County, Lyon County, Nye County, Storey County, and Washoe County for groups in 10 SIC Codes:
- Agriculture, Forestry, & Fishing (0100-0999)
- Mining (1000-1499)
- Manufacturing (2000-3999)
- Transportation, Communications, Electric, Gas, and Sanitary Service (4000-4999)
- Wholesale Trade (5000-5199)
- Retail Trade (5200-5999)
- Finance, Insurance, and Real Estate (6000-6799)
- Services (7000-8999)
- Public Administration (9100-9729)
- Non-classifiable (9900-9999)
Working With Word & Brown on AHP Cases
When you work with Word & Brown on your Prominence Health Plan AHP cases, you get access to our value-added benefits. Those include an amazing sales team dedicated to your success, 100% rate accuracy, in-house compliance experts, and much more. Best of all, you don’t pay anything for Word & Brown’s services. Your competitive compensation is the same when you write AHP through us as if you were to write the coverage directly through Prominence.
If you’re ready to increase your commissions by offering Association Health Plans to your Nevada groups, login now to start your quote – or contact Ken LaRovere (775-342-5340) or Mona Hannah (800-606-4996).
A final note about California: While smaller organizations can no longer take advantage of AHPs in California, one option still available is a Professional Employer Organization (PEO), sometimes referred to as an employee leasing company. With a PEO, the responsibility for HR and benefits moves from the employer to the PEO, acting as an intermediary to hire workers, manage payroll, etc. If you’re interested in learning more about PEOs and human resource outsourcing, talk with your Word & Brown representative.
Notes: Membership in the Reno + Sparks Chamber of Commerce or an affiliate program is required to take advantage of Prominence Health Plan AHP plans. Existing groups with AHP coverage can maintain their current plan until September 1, 2021, or they can enroll in new AHP coverage before September 1, 2021, for an extended contract.