A new rule issued by the Department of Labor in 2018 expanded the availability of association health plans (AHPs) for small businesses. AHPs allow small businesses to band together within industries, professions, or geographic regions to either purchase large-group coverage or self-insure.
In North Carolina, this is a popular option and it exists in many state for Dental Associations. The NC Dental Society offers an Association plan that allows a Practice owner to open up “group” insurance to his or her staff. More information about the plan specifics can be found here.
Once the benefit is in place, it works much like a regular group policy or self-funded health insurance benefit would. However, AHPs aren’t subject to the ACA’s rating rule, which prevents insurers from varying costs in a specific region based on things like sex, age, or health status. They also don’t need to cover the essential health benefits that ACA-compliant policies do.
Administration is typically done by the association, rather than by the small business members.
AHPs can help cut costs, often by between $1,900 and $4,100 per employee per year. However, AHPs achieve these cost savings not only by widening the risk pool, but also by cutting out standard coverage items. The AHP may not cover essential health benefits, such as prescription drugs, maternity care, or mental health services.
The NC Dental Society plans are competitive to group policies and offer a valid option for Practice owners. If you make the decision to offer the plan, you still need to understand your option on how you pay for the plan for employees and yourself – both of which have tax implications.
If you have questions or would like to connect with a health insurance partner in your area, contact us today!