HB 2376 — requirements; association health plans

HB2376 - 541R - H-Health & Human Services-ProposedServices - Strike Everything-Proposed   Fifty-fourth Legislature                                  Health & Human Services First Regular Session                                                   H.B.

2376 (Reference to theprinted proposedbill) Barto  s/e  amendment  datedStrike 2/12/19;everything after the enacting clause and insert:

10:09"Section 1.  Title a.m.)20,  chapter  13,  Arizona PageRevised 2,Statutes, lineis 13,amended afterby "must"adding insertarticle ":3, to read:

1."ARTICLE Between3.  ASSOCIATION linesHEALTH 14PLANS andSTART_STATUTE20-2351.  Definitions 15,In insert:this article, unless the context otherwise requires:

"2.  Include1.  "Association thehealth essentialplan" means, for a health benefits requiredplan issued by thean patientaccountable protectionhealth andplan, affordablea caregroup actor (P.L.association of employers that meets the requirements of section 20‑2352.

111‑148).2.  "Self‑insured association health plan" means an association health plan that is not fully insured.

3.  Not3.  "small excludeemployer" anyhas preexistingthe conditions."same Amendmeaning titleprescribed toin conformsection  20‑2301  and KELLImay BUTLERinclude  a  sole 2376BUTLERproprietor 02/13/2019or 10:45working AMowner. C:

mh4.  "Working  Owner"  means an individual whom a responsible plan fiduciary reasonably determines is an individual who meets all of the following requirements:

(a)  Has an ownership right of any nature in a trade or business, whether incorporated or unincorporated, including a partner and another self‑employed individual.

(b)  Is earning wages or self‑employment income from a trade or business for providing personal services to the trade or business.

(c)  either:

(i) Works on average at least twenty hours per week or at least eighty hours per month providing personal services to the working owner's trade or business.

(ii) Has wages or self‑employment income from a trade or business that at least equals the working owner's cost of coverage for participation by the working owner and any covered beneficiaries in the group health plan sponsored by the group or association in which the individual is participating.

END_STATUTE START_STATUTE20-2352.  Association health plans;

self‑insured association health plans;

definition A.  An association health plan that forms for the purpose of offering a health plan to the employees, including working owners, of its employer members must meet the primary purpose, commonality and nondiscrimination standards and requirements of 29 Code of Federal Regulations part 2510.

B.  In determining group size, the employees, including working owners, of participating employers in the association health plan shall be counted in the aggregate.

C.  A self‑insured association health plan that operates in this state:

1.  At all times shall be in compliance with federal law and regulations.

2.  Shall be governed and operated in accordance with sound actuarial principles.

3.  Is subject to chapter 2, article 6 of this title.

4.  Is otherwise not subject to the requirements of this title.

D.  For the purposes of this section, "employer" includes a small employer.

END_STATUTE START_STATUTE20-2353.  Notification An insurer that issues a health plan to an association health plan shall notify the department at the time the insurer submits policy form filings.

END_STATUTE Sec. 2.  Department of insurance;

association health plans;

summary On or before January 1, 2020, the department of insurance shall post information on the department's public website that summarizes the applicable state law and any other pertinent information related to association health plans." Amend title to conform     NANCY K.

BARTO     2376BARTO 02/12/2019 10:09 AM C:

MH