Association Health Plans Act
- Bill Number
- H.R. 2528
- Origin Chamber
- House
- Congress
- 119th Congress, Session 1
- Policy Area
- Health
- Status
- Introduced
- Latest Action
- 2025-12-15: Placed on the Union Calendar, Calendar No. 357.
- Last Updated
- 2026-06-11T05:06:22Z
AI-Generated Summary
Purpose This legislation amends the Employee Retirement Income Security Act of 1974 (ERISA) to expand the definition of an "employer" for the purpose of sponsoring group health plans. It enables certain groups or associations of employers—regardless of whether they operate in the same industry—to form and maintain association health plans (AHPs) that qualify as single-employer plans under ERISA, with the goal of increasing access to group health coverage for small businesses and self-employed individuals.
Key Provisions
- Expanded employer definition: Amends ERISA Section 3(5) to treat a group or association of employers as a single "employer" if it meets criteria such as maintaining a group health plan covering at least 51 aggregated employees, existing for at least two years, operating in good faith for non-healthcare purposes, prohibiting health-status discrimination, and having a governing board with at least 75% employer members.
- Self-employed individuals: Allows self-employed persons (those with no common-law employees, bona fide business ownership, earned income, and working at least 10 hours weekly) to join as employer members and plan participants, subject to initial and ongoing eligibility verification by the association board.
- Premium rating rules: Adds ERISA Section 736 permitting modified community rating with base premiums pooled across all participants, plus risk adjustments for individual employer members. Plans consisting solely of self-employed individuals must charge uniform rates to all participants.
- Nondiscrimination and coverage protections: Prohibits eligibility rules or premium variations based on health status factors and bans denial of coverage due to pre-existing conditions, consistent with existing ERISA and Public Health Service Act rules.
- Rule of construction: Ensures AHPs remain subject to all other ERISA Part 7 requirements, including mental health parity and other consumer protections.
- Employer status clarification: Provides that offering coverage through such an association does not create an employer or joint-employer relationship under federal or state law.
Significant Changes to Existing Law
- Broadens the ERISA "employer" definition beyond traditional single employers or same-industry groups, incorporating criteria previously addressed in Department of Labor advisory opinions.
- Explicitly includes self-employed individuals in AHPs and aggregates all participants across member employers for counting and regulatory purposes.
- Introduces statutory authority for modified community rating and risk-based contribution adjustments within AHPs, subject to state law limits.
- Codifies nondiscrimination standards and pre-existing condition protections directly into the new framework.
Potential Impacts
- Government agencies: The Department of Labor gains clearer enforcement authority over AHPs but must monitor compliance with eligibility, governance, and nondiscrimination rules; states retain authority over certain insurance regulations.
- Citizens: Small employers and self-employed individuals may gain access to larger risk pools and potentially lower-cost coverage, though actual availability depends on state laws and market participation.
- International relations: No direct effects identified.
Main Stakeholders Affected
- Small businesses and employer associations seeking to sponsor health plans.
- Self-employed individuals seeking group coverage.
- Employees of participating employers.
- Health insurance issuers that may participate as members or service providers.
- The Department of Labor as primary regulator.
- State insurance regulators overseeing aspects of plan operations.
Notable Legal, Constitutional, or Political Implications
- Strengthens federal preemption under ERISA for qualifying AHPs while preserving state authority in areas not directly addressed.
- Addresses prior regulatory uncertainty by codifying treatment of AHPs, potentially reducing litigation over multiple-employer welfare arrangement status.
- Raises no apparent constitutional issues but operates within the existing framework of ERISA’s employee benefit protections.
This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.
Sponsor
Cosponsors (32)
Rep. Allen, Rick W. [R-GA-12], Rep. Onder, Robert [R-MO-3], Rep. Crenshaw, Dan [R-TX-2], Rep. Bice, Stephanie I. [R-OK-5], Rep. Kiley, Kevin [R-CA-3], Rep. Grothman, Glenn [R-WI-6], Rep. Mackenzie, Ryan [R-PA-7], Rep. Huizenga, Bill [R-MI-4], Rep. Owens, Burgess [R-UT-4], Rep. Harris, Mark [R-NC-8], Rep. Thompson, Glenn [R-PA-15], Rep. Hill, J. French [R-AR-2], Rep. Smith, Adrian [R-NE-3], Rep. Biggs, Andy [R-AZ-5], Rep. Cuellar, Henry [D-TX-28], Rep. Van Drew, Jefferson [R-NJ-2], Rep. Weber, Randy K. Sr. [R-TX-14], Rep. Fischbach, Michelle [R-MN-7], Rep. Hunt, Wesley [R-TX-38], Rep. Goldman, Craig A. [R-TX-12], Rep. Gosar, Paul A. [R-AZ-9], Rep. Messmer, Mark B. [R-IN-8], Rep. Smith, Christopher H. [R-NJ-4], Rep. Ciscomani, Juan [R-AZ-6], Rep. Hamadeh, Abraham J. [R-AZ-8], Rep. Bishop, Sanford D. [D-GA-2], Rep. Meuser, Daniel [R-PA-9], Rep. Barr, Andy [R-KY-6], Rep. Dunn, Neal P. [R-FL-2], Rep. Calvert, Ken [R-CA-41], Rep. Fitzgerald, Scott [R-WI-5], Rep. Schweikert, David [R-AZ-1]
Recent Actions
- 2025-12-15: Placed on the Union Calendar, Calendar No. 357.
- 2025-12-15: Reported (Amended) by the Committee on Education and Workforce. H. Rept. 119-409.
- 2025-12-15: Reported (Amended) by the Committee on Education and Workforce. H. Rept. 119-409.
- 2025-06-25: Ordered to be Reported (Amended) by the Yeas and Nays: 21 - 15.
- 2025-06-25: Committee Consideration and Mark-up Session Held
- 2025-04-01: Referred to the House Committee on Education and Workforce.
- 2025-04-01: Introduced in House
- 2025-04-01: Introduced in House
Bill Versions
- Association Health Plans Act — issued 2025-04-01 — PDF (10 pages)
- Association Health Plans Act — issued 2025-12-15 — PDF (14 pages)