The Washington Office of the Insurance Commissioner (OIC) has updated its lists of 2014 and 2015 association health plans approved and disapproved. The charts break out filed plans into four categories – approved; disapproved because the association is not “bona fide”; disapproved because the rates fail to conform to the new AHP rate rules; and “under review” which means they haven’t decided what to do yet either because of rate or bona fide status or both.
Here are the only association health plans which have been approved to date. All of them are plans filed in 2014:
|Associated General Contractors of Washington||UnitedHealthcare|
|Association of Washington Cities||Group Health Cooperative|
|Central Region Insurance Services Pool||Group Health Options, Inc.|
|Central Region Insurance Services Pool||Group Health Cooperative|
|Hanford Employees Welfare Trust||Group Health Options, Inc.|
|Lutheran Services of the Northwest||Group Health Cooperative|
|Lutheran Services of the Northwest||Group Health Options, Inc.|
|Master Builders Association (MBA)(Rates)MBA Group Insurance Trust(Forms)||Group Health Options, Inc.|
|Microsoft Alumni Network Benefits Trust||Premera Blue Cross|
|Washington Fire Commissioners Association||Group Health Cooperative|
You can view the rest of the filed association plans and their status at the 2014 and 2015 links above.
The most interesting of the approved plans is the Microsoft Alumni Network Benefits Trust. According to the Microsoft Alumni Association website, “We offer group health insurance for business owners through Premera and individual health insurance through eHealthInsurance.”
I don’t know how the U.S. Department of Labor would square up the Microsoft association against its prior opinions. The alumni association commonality test for “bona fide” status doesn’t seem to be the type of relationship typically approved by DOL. I’d like to know how the OIC managed to find this association “bona fide” and not some of the others on the “disapproved list” given the direction from DOL in its published guide:
In order for a group or association to constitute an “employer” within the meaning of Section 3(5), there must be a bona fide group or association of employers acting in the interest of its employer-members to provide benefits for their employees. In this regard, the Department has expressed the view that where several unrelated employers merely execute identically worded trust agreements or similar documents as a means to fund or provide benefits, in the absence of any genuine organizational relationship between the employers, no employer group or association exists for purposes of Section 3(5). [Guide at 8]
Apart from the fact that the association employers once worked for Microsoft, how do these former employers constitute the type of nexus described by DOL and not get tagged as “several unrelated employers” getting together for benefits? The only apparent relationship among the employers is the one that comes from the benefits offered by participation in the association. For a sample of various DOL opinions on the matter, you can view an analysis here.
In the meantime, the OIC should include in its determinations of “winners and losers,” the reasons why the OIC found that an association met or failed to meet DOL standards. As long as the OIC will be issuing opinions, it should follow the DOL lead and catalog and publish its bona fide opinions. Such a catalog would inform future efforts by associations to create bona fide employer plans satisfying state law.