On Oct. 29, 2018, Ins. Commissioner Caride issued bulletin No. 18-13 regarding association health plans.
As background, on June 21, 2018, the DOL issued final regulations regarding AHPs and expanded the definition of an “employer” for associations that could sponsor group health coverage. The regulations permit an association to form for the sole purpose of offering an AHP (or MEWA) to its members, provided the association maintains a commonality of interest. Essentially, the DOL made it easier for association-sponsored plans to offer group health coverage and be treated as a single “employer” for ERISA purposes to allow treatment similar to large-group coverage.
This bulletin points out that the DOL’s final regulations explicitly state that traditional oversight and regulatory authority over AHPs/MEWAs remains with the states and does not modify or limit existing state authority under ERISA. Any state law regulating insurance may apply to the AHP, to the extent that it isn’t inconsistent with ERISA. NJ law also extends to policies issued outside of NJ.
The intended purpose of the bulletin is to advise carriers, brokers and other interested parties that the recent federal rulemaking related to association health plans (AHPs) does not modify or preempt NJ’s existing regulatory authority and oversight regarding MEWAs, and any AHP operating, expanding or otherwise marketed in NJ. Ultimately, a MEWA or AHP, whether insured, partially-insured or self-funded whether organized in NJ or another jurisdiction may not market (that is, sell, solicit or negotiate) its plan in NJ unless it complies with all applicable NJ laws and regulations.
Bulletin 18-13 »