Payers Partner with Trade Orgs to Roll Out Association Health Plans

October 09, 2018 - Healthcare payers are beginning to launch partnerships with trade organizations and chambers of commerce to provide association health plans (AHPs) to small businesses and contractors.

The roll out of AHPs follows federal and state efforts to position AHPs as an option for individual or small group ACA health plans. Small businesses and contractors can form association groups to purchase health plans that are generally less expensive than products offered through the ACA exchanges.  

However, many AHPs offer fewer benefits and less comprehensive coverage than ACA plans due to the fact that they are not bound by ACA consumer protection rules. Some states have imposed additional regulations on the AHP market to ensure that consumers have access to AHPs that include the ACA’s list of essential health benefits.

States that have actively supported AHP expansion may wish to prepare for an influx of new AHP products as small business groups promote and offer AHPs to potential consumers.

Transcend AHP partners with BCBS of Michigan to offer small business health plans

The Small Business Association of Michigan and MichBusiness are offering a new AHP called Transcend Michigan to small businesses with a maximum of 50 employees and contractors affiliated with either group.

READ MORE: How Payers Can Succeed in Association Health Plan Markets

Transcend plans will pool small groups and single beneficiaries into a customized multiple-employer benefit plan. The plans are managed through BlueCross BlueShield of Michigan and the Blue Care Network, and provide beneficiaries with several health plan options with different premium and deductible levels.

Transcend beneficiaries can choose products that provide health plan benefits similar to BCBS of Michigan commercial insurance packages. Some health plan options, including the Simply Blue PPO for small groups, cover essential health benefits as defined by the ACA.

Nebraska Farm Bureau and Medica Health Plans offer AHP to lower premiums

The Nebraska Farm Bureau (NEFB) has partnered with Medica to provide an association health plan in order to lower costs for farmers in the state.

NEFB has found that the cost of health insurance is one of the most impactful stressors for the state’s agricultural workers.

“The last couple of years we have heard stories from farmers and ranchers about the high cost of health insurance for their families,” said NEFB President Steve Nelson. “When farm and ranch families in Nebraska are facing $25,000 to $40,000 per year for health insurance premiums, the financial stress on those family operations are extremely high, very emotional, and can easily impact whether they can stay in the business of agriculture.”

READ MORE: Managed Care Payers Struggle to Staff Long Term Support Services

The NEFB health plan provides insurance options to NEFB members that have been in good standing with the organization since July 1, 2018. NEFB health plan members must produce 50 percent of their income from agricultural businesses and have 50 or fewer employees. Agricultural employees that work 30 hours a week or more are also eligible to enroll.

NEFB benefit packages include broad provider network access or narrow network coverage for individuals and families. Members receive benefits including access to centers of excellence, online preventive care services, and 24/7 telehealth access to a nursing professional.

Members in the broad network package pay 30 percent of costs in coinsurance after they hit their deductible for medical services, including emergency room visits. Narrow network beneficiaries pay 20 percent of coinsurance for the same medical services.

Nevada chambers of commerce form AHPs for small businesses and contractors

The Henderson Chamber of Commerce, Latin Chamber of Commerce, and Boulder City Chamber of Commerce have launched an association health plan to cover medical, dental, and vision benefits for small businesses and contractors in Nevada.

Small businesses could use the AHP to attract new hires and become more competitive, according to chamber leaders. The three chambers partnered with Health Plan of Nevada and Sierra Health and Life to provide HMO, PPO, and POS health plan packages that cover medical, pharmacy, and wellness benefits. AHP members can also access telehealth consults and add dental and vision coverage.

READ MORE: How Payers Can Develop a Medication Therapy Management Program

Recently, the Reno + Sparks Chamber of Commerce also launched an association health plan in order provide small businesses with competitive health plan packages.

“This is a game-changer for our members with less than 50 employees and creates a more level playing field to compete with larger organizations for recruitment and retention of qualified workers,” said Ann Silver, CEO of the Reno + Sparks Chamber of Commerce.

Reno + Sparks partnered with Prominence Health Plan to provide the Chambers’ Association Health Plan (CAHP). Leaders at Prominence Health Plan believe CAHP offers an affordable and competitive benefits package for small businesses across the Reno area.

“We at Prominence Health Plan feel privileged to partner with The Chamber to enable a more affordable, high quality, customer-focused solution to The Chamber small employer group members,” said Kamal Jemmoua, COO, Prominence Health Plan.

“Small business owners have numerous challenges recruiting and retaining top talent to achieve their business goals and aspirations –– we hope we can be a small part of further enabling them.”