Members urged to comment on association health plan rule

Director of Public Policy Simone Radcliffe is asking member associations to file comments on the Department of Labor's proposed rule on association health plans before the comment period closes.

The proposed rule would narrow the "common interest" test associations must meet to sponsor a group health plan on behalf of their member organizations. Under the current standard, an association qualifies if its members share a trade, industry, or profession in common. The proposed rule would require a tighter showing — that the association's members also share the plan sponsor's specific business purpose, not just a broad sector.

Radcliffe said the narrower test would disqualify some of the plans associations like NANA's members currently rely on, particularly ones built around a professional society rather than a single trade.

Group health coverage through an association plan is often the only affordable option for a small member organization's staff. A narrower common-interest test could force some of those plans to restructure or dissolve, pushing small associations back onto the individual market for staff coverage.

Meridian Benefits Group, which builds group health and retirement plans for association staff and is one of NANA's Presenting sponsors, has told NANA it is reviewing which of its current association-sponsored plans would still qualify under the proposed language.

Radcliffe said the practical effect would fall hardest on associations with fewer than 20 staff, where the administrative cost of setting up a standalone plan, rather than joining an existing association-sponsored one, can exceed what the coverage itself costs. A single-employer group plan typically requires a minimum enrollment the smallest associations can't reach on their own, which is precisely why the association-sponsored model exists in the first place.

"The associations most likely to lose coverage under this rule are the ones with the least capacity to build a replacement," Radcliffe said. "A 40-staff trade association can absorb the disruption. A nine-person coalition can't."

NANA has been tracking this rulemaking since it was first proposed, and Radcliffe said the comment period represents the clearest opportunity members will have to shape the final rule before it's finalized. Comments that come from associations currently using an association-sponsored plan, describing specifically how their coverage would change under the narrower test, tend to carry more weight with the Department of Labor than comments opposing the rule in general terms.

• Read the proposed rule text and NANA's position at association-health-plan-rulemaking

• File a comment before the window closes, especially if your association currently sponsors or participates in a group health plan for members

• Ask your plan administrator directly whether your current plan would qualify under the narrower common-interest test

• Contact NANA's public policy team with specific examples of how a plan disruption would affect your staff — member comments citing real numbers carry more weight than general opposition

NANA's own comment will focus on associations under 50 staff, where losing a group plan option has the largest per-employee cost impact. Radcliffe said the policy team will post the final comment publicly once it's filed, so members can see the specific language NANA used.