Oscar looks to sell health insurance in three more states

Oscar looks to sell health insurance in three more states

Oscar looks to sell health insurance in three more states

It's an important step in reversing a multi-year downward trend in the number of small business owners offering health insurance to their employees as a result of rising premiums and increasing deductibles.

Despite the promising new opportunities for AHPs, the regulations expressly state that the new guidance does not modify existing state authority to regulate MEWAs.

The rules, throwing the doors wide open to a type of insurance known as association health plans, accomplish through executive power what congressional Republicans have tried and failed to write into law over the past two decades. Conservative groups lauded the new rule as a way to expand affordable coverage and lower healthcare costs.

The Trump administration announced the finalized rule yesterday that would give small businesses access to insurance options like those available to large companies and let them skirt some of the health law's requirements.

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Although employers of all sizes would be eligible for the rule's new AHP option, employers now in the small group or individual market are likely to be most interested, because combining in an association that covers 50 or more employees would put them in the large group market, where ACA requirements like essential health benefits (EHBs) do not apply.

But they won't have to offer all the same benefits as plans bought by individuals on the Obamacare exchange.

America's Health Insurance Plans, the main trade group for insurers, said it was wary of anything that could disrupt the existing markets under Obamacare.

The Trump administrationtook the final step Tuesday in its plan aimed at making health insurance policies cheaper for some small businesses. Until today, these entrepreneurs were often left with no coverage option other than the individual market, where premiums costs for benchmark plans doubled between 2013 and 2017, according to Health and Human Services. The new rule will begin applying to plans over the next year.

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Like the version proposed in January, the final rule allows employers with a "commonality of interest" to offer joint coverage without numerous restrictions that previously applied to coverage provided through associations. This reform will help empower small businesses with the kind of buying power that has always been available to large employers, and as a result, many more small businesses will be able to gain access to coverage. This allows them to retain some say in what benefits are offered and to monitor the financial health of the plans, depending on how the associations are set up. The agency also cited commenters on the proposed rule who observed that most small businesses can join a chamber of commerce or professional association, and that "a proliferation of groups or associations established for the exclusive objective of sponsoring an AHP" could diminish the value of such organizations.

The rule also attempts to strengthen oversight of AHPs by requiring associations to have a formal organizational structure with a governing body and bylaws so they can act in the interests of participating employers and ensure claims are paid.

Trump himself has said AHPs will provide businesses with "tremendous insurance at a very low cost".

The proposed regulation would allow associations to base an employer's rates on the gender, age and industry of its workers, which could leave firms with manyyounger men paying less, but those with older workers and women saddled with higher premiums.

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Health providers, insurers and medical groups have warned that the plans could drive up premiums and make insurance unaffordable for some people by siphoning off healthy consumers who want cheaper coverage, leaving behind a sicker patient pool with higher medical costs in Obamacare plans. Employers can continue to form nationwide AHPs for businesses in their specific industry.

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