Las Vegas Sun

December 10, 2018

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Association health plans gain foothold with Nevada members

RENO — With members struggling to meet health insurance costs, some Nevada business and trade groups have begun offering discounted policies as one big bloc through a product known as an association health plan.

The Reno-Sparks Chamber of Commerce and five other Nevada associations have begun offering similar health plans to members, the Reno Gazette Journal reported.

Others are the Las Vegas Metro and Henderson chambers, the Nevada Contractors and Nevada Builders Alliance associations, and the Builders Association of Northern Nevada.

Reno-Sparks chamber CEO Ann Silver called the option a game-changer for small businesses competing to attract and retain skilled employees.

"Health insurance has been, for at least a decade, unaffordable for small employers," Silver said, "but small businesses struggle to recruit and retain employees without it."

Bob Fehling, president of Reno general engineering contractor Versa Grade, said that for more than a decade he was beset by annual double-digit increases in costs and diminished health care.

"The costs keep getting greater and greater and greater while the coverage of the plan decreases," Fehling told the Reno Gazette Journal. "We're paying more for less."

Fehling, who decided to join the Reno-Sparks Chamber Association Health Plan, called it a marked improvement over previous options.

"It has lower deductibles and lower out-of-pocket costs," he said. "It has better coverage and lower total cost all the way around."

A Gazette Journal project found that in Nevada, fully-insured association health plans are overseen by the state because they're offered through traditional insurance carriers such as Prominence, Health Plan of Nevada and Hometown Health Plan.

As the name implies, association health plans pool small businesses to obtain rates like those typically available to larger employers. They fall under a broader category of services known as multiple employer welfare arrangements, which provide members with health and welfare benefits.

Their origins can be traced to the Employee Retirement Income Security Act of 1974.

Association health plans had a checkered past before gaining renewed interest after the U.S. House of Representatives in March 2017 passed the Small Business Health Fairness Act. It created federal requirements for the plans, including certification, coverage and rates for contribution.

President Donald Trump signed an October 2017 executive order to further expand their availability to small businesses, and the Department of Labor eased conditions and requirements for the plans.

Department rules took effect Sept. 1 for fully insured association health plans and will take effect in early 2019 for self-funded plans that are not tied to an established insurance carrier.

Not everyone supports the idea.

"We've run this experiment before and we saw a lot of fraud and a lot of mismanagement," said David Chase, vice president of national outreach for Small Business Majority, a network of 58,000 small business owners and 1,000 business partners including chambers of commerce, economic development groups and workers associations.

"At the end of the day, the victims were small business owners and employees. They were the ones left holding the bag the last time we went down this track."

Stacey Bollinger said she heard association health plan horror stories in the past. But she and her husband Mark, owners of Sierra Nevada Door & Window, signed their staff of 10 up for a Nevada Builders Alliance plan that counts more than 800 companies among its members.

The Gazette Journal reported that coverage, provided through Prominence, was 30 percent cheaper than what Sierra Nevada Door & Window had been paying.