SIIA Comments on Association Health Plan Proposal

SIIA Urges DOL to Issue Class Exemption to State MEWA Laws

March 5, 2018 - The Self-Insurance Institute of America, Inc. (SIIA) filed formal comments with the Department of Labor (DOL) in response to the Notice of Proposed Rule-Making (NPRM) relating to Association Health Plans (AHPs). Specifically, SIIA used the comments as an opportunity to respond to a Request for Information (RFI) on the potential issuance of a "class exemption" that would exempt self-insured MEWAs from the non-solvency requirements of State MEWA laws. The full comments filed with the DOL can be found here.

The stated goal of the AHP proposal is to expand affordable health coverage among small employers and self-employed individuals through both fully-insured and self-insured group health plans. However, in doing so, self-insured plans may have an up-hill battle as they would be considered multiple employer welfare arrangements (MEWAs) governed under each individual state MEWA law, which creates a patchwork set of non-uniform regulations.

SIIA believes that this patchwork set of regulations - especially State laws that prohibit self-insured MEWAs - adversely affects consumer choice. As a result, SIIA supports a more reasonable - and appropriate - way of regulating self-insured MEWAs through a uniform set of Federal requirements that must be met so a self-insured MEWA can offer health coverage in multiple States.

In summary, SIIA requests that the DOL issue a "Class Exemption" to provide uniformity in the law, based on the fact that:

  • Self-insured MEWAs offer quality and affordable coverage;
  • Such an exemption will promote healthcare choice and competition;
  • A class exemption will not put at risk the appropriate regulatory oversight of self-insured MEWAs;
  • State reserve and contribution requirements will continue to apply;
  • Self-insured MEWAs already provide adequate consumer protections; and
  • Actuarial Soundness, adequate underwriting and adequate underwriting practices should be put in place in developing the RFI.

This RFI is a pre-cursor to a potential future rule-making process and these comments can influence final AHP regulations. Therefore, SIIA will be communicating further details on any further activity on the AHP rule, as well as any actions regarding the RFI itself.

If you have questions or would like to talk further about the comments filed, please Ryan Work, SIIA Vice President of Federal Government Relations, at