Insurance producers:
This is an update about the Office of Insurance Commissioner's review of association health plans in Washington.
Since January 2014, we have been reviewing all association health plans as they renew. To date, we have approved 11 plans, including the most recent approval for the Washington Education Association.
Our review is focused on two factors:
- Does the association meet the federal definition of
being a true large employer?
- Are the rates fair?
How the review process works:
- Large-employer status. First, we determine if
an association meets the federal test of being a true or bonafide large
employer and therefore able to sell large-employer coverage. Association
members must share a common industry or trade and the association must
be formed for a purpose other than to sell health insurance. If an
association does not meet this definition, it can still offer health
insurance to its members, but it cannot offer a large-employer health plan
to its members.
- Review of rates. Second, we review rating practices. Rates must be fair in relation to the benefits. This is true for every health insurance plan, not just for association health plans. If the rates are not justified, the plan is disapproved.