Tennessee REALTORS® recently launched one of the first AHPs for a professional association under the new rules after a survey of members showed strong interest in the kinds of benefits that could be provided. The group has 21 local chapters and 29,000 members statewide.

Membership of the group (full disclosure: a HUB International client) has the classic profile of the types of small businesses whose interests are underserved in the current health care marketplace—1099 contractors, W2 employees and sole proprietorships/partners and owners. The survey found 94 percent were interested in accessing benefits through a Tennessee REALTORS® sponsored AHP; 50 percent identified as individuals who believed they were paying too much for their health care coverage.

The fully insured AHP solution offers a robust range of options for members, their employees and dependents. That includes three different medical plan options; a dental and vision option; and wellness solutions. Non-medical benefits also are offered, such as accident with a disability insurance rider, critical illness and life insurance with a long-term care rider. Premiums are competitive in a state where prices, on the whole, stabilized or declined for 2019 after years of double digit increases.

In addition to opening the doors for small businesses to previously inaccessible, big business-type benefits, AHPs can make a difference in environments that lack competition for health plans. Take Nebraska, with a single insurer offering coverage on the ACA exchange that had a 9.1 percent jump in the 2019 premium of its second lowest cost silver plan to $686 before subsidies.

It's made AHPs such as Land O'Lakes, a farmer-owned cooperative, welcome. Its self-insured plan is expanding across state lines with the new rule, offering savings of 25 percent to 35 percent over Nebraska's exchange plans and 10 percent to 12 percent over comparable plans in Minnesota's.

Are AHPs the panacea for small businesses in search of adequate or better medical coverage at affordable rates? As in everything else, the rule of “caveat emptor” applies. Not every plan, its structure or lineup of benefits and fees will be equal. It pays to read the fine print. Small businesses whose states allow them and that believe their companies and employees might benefit by joining one should start the process by investigating along three lines of inquiry:

1. AHP membership parameters

• Who will be invited to join?
• What are the terms for adding new members?
• What are the rules over leaving the AHP pool?

2. Health plan options and benefits covered

• What specific health plan options are included in the AHP?
• How does this affect your competitive advantage when hiring new employees or retaining current workers?

Consider establishing some benchmarks for competitive comparison. Cost is important, but so are other factors. In balancing benefits and costs, for example, weigh things like the menu of services for the cost, out-of-pocket maximums and how the pharmacy benefit is structured. Customer service is key, too, like turnaround on claims

3. Added costs of administration

• What's the cost to administer an AHP?
• Who will be responsible for paying this cost?
• Who can counsel you to navigate and understand costs/fees?

Today's new and improved Association Health Plans are still a work in progress. But designed with a critical eye toward all the elements that successfully come together in best-of-class health plans – not just price, but value in terms of holistic and forward-thinking benefits and services – they may give a positive boost to our pressured health care system.

Margaret Collignon is vice president of employee benefits at HUB International, and Matt Cowan is president of Tennessee Operations.