Request a call Login

  • On April 29, 2024, the U.S. Department of Labor (DOL) finalized a rule reversing a Trump-era regulation designed to expand the formation and use of Association Health Plans (AHPs), without having to comply with the requirements of the Affordable Care Act (ACA). AHPs are group health plans that cover small employers and self-employed individuals in the same or different industries. AHPs, which are governed by state and federal laws, have historically varied significantly in size and membership.

    The 2018 Trump Administration Rule

    The 2018 rule from the Trump administration that expanded AHPs was struck down by a federal judge in 2019 and was never fully implemented. The DOL stated the 2018 rule expanded the definition of AHPs in a way that would have allowed some individual and small group health insurance coverage to be treated as large group coverage. This change could potentially evade critical consumer protections under the ACA, which requires coverage of essential health benefits such as emergency and maternity newborn care.

    The New Final Rule

    The new final rule from the Biden administration, issued by the DOLs Employee Benefits Security Administration, will take effect 60 days after its April 30th publication. It is intended to ensure consumers have access to quality health coverage consistent with federal law, including the ACA’s requirements for essential health benefits.

    While some proponents of the AHP argue they can provide small businesses and self-employed individuals with better bargaining power and lower prices, critics contend the 2018 rule would have undermined important ACA consumer protections. The new rule has been supported by the Biden administration but criticized by some Republican lawmakers as limiting workers’ health care options.

    Managing These Changes

    GMS can help your company stay compliant with the DOL’s new rule on AHPs and managing the associated challenges. Our team of HR and benefits experts can assist with analyzing your current health care plan offerings, determining the appropriate compliance requirements, and implementing necessary changes to ensure you are providing employees with quality, ACA-compliant coverage.

    In addition, we provide guidance on navigating legal and regulatory uncertainties, training programs for managers and employees on the new rules, and ensuring your benefits administration processes are updated. By partnering with GMS, you can confidently navigate these complex regulatory changes and avoid potential penalties or disruptions in your employee health benefits. Contact us today to learn more.

  • When Donald Trump ran for the Presidency in 2016, a major plank of his platform was the repeal and replacement of the Affordable Care Act. In fact, pretty much every Republican in 2016 ran on that promise.

    In the summer of 2017, several Republican Senators and every Democrat Senator torpedoed that promise by not agreeing to a plan. Since then, this administration has made several attempts to sink the ACA where they could.

    A gavel of a judge blocking new association health plan rules meant to sink the affordable care act.

    The Trump Administration’s Attempts to Sink the ACA Through AHPs

    The first, and perhaps most powerful as far as Washington D.C. is concerned, attempt is the decision to no longer enforce the individual mandate. If you recall, there was supposed to be a financial penalty on any individual who didn’t have an insurance plan through an employer or on their own. The problem with that plan was always twofold:

    • If you weren’t working or weren’t filing taxes, there was no way for the IRS to collect that penalty.
    • In many instances, the penalty was less costly than the insurance itself.

    The administration began creating new rules for Association Health Plans (AHPs). These AHPs allowed “businesses and individuals [to] band together to create group health plans that offer less expensive coverage than the ACA.” In other words, Associations could pull together multiple employers and individuals into a larger group, offering better rates. In most cases, the trade-off was no protections for what was deemed “minimal coverage.”

    Recently, a federal judge ruled that the Trump Administration attempted an “end run” around the ACA and, in effect, violated the Affordable Care Act.

    Affordable Healthcare Options for Business Owners

    If you are a business owner and you thought these plans were a way to get out from under the considerable financial burdens of the ACA, you may be back at square one.

    Well, there may still be a multiple-employer healthcare option for you. If you would like to learn more about the large group buying power of a Professional Employer Organization (PEO), as well getting additional HR services and regulatory and tax protections, please contact GMS to talk to one of our experts today.