Texas Association Health Plans

Any great relationship starts with a conversation, so let’s start there.

Important Notice

Due to a ruling by a U.S. District Court judge on March 28, 2019, most carriers have suspended proposals for Employer Association Health Plans. Read More Here.

UnitedHealthcare has announced a state-wide initiative to take advantage of the recently passed legislation allowing for expansion of health insurance to be offered for members of Associations. This means that by joining a local Chamber of Commerce, you could take advantage of insurance premium savings.

The savings depends on many variables such as size of your organization, age of participating employees, and more. The average savings is said to be around 5% to 15% on premiums.

Requirements for Association Health Plans

In order for companies and non-profit organizations to participate in an association health plan, they must meet several criteria:

  • Must be a member of a participating Association
  • Employ between 2 and 50 full-time eligible employees

If you are looking for a participating association, you can look into joining a local Chamber of Commerce.

Several Chambers, including the Grapevine Chamber, NW Metroport Chamber and HEB Chamber have joined together to create the North Texas Employer Health Plan Cooperative. This association primarily benefits those businesses within Tarrant County.

However, for Dallas County businesses, there is the Collin County Cooperative.

Before Your Join a Chamber of Commerce or Participating Association

It is not guaranteed that your organization will save on insurance premiums by joining one of these associations listed above. Our professional insurance agents are able to find out what your premiums will be both using an association and without, prior to you joining.

Once you have evaluated the medical proposals, then you will know whether or not there is a direct benefit to joining an association.

Time Frame & Deadlines

If you already have benefits in place at your organization, it’s likely that your renewal is just around the corner on January 1st. If that’s the case, you will need to act fast to explore this opportunity. Many companies require you to submit your applications and make a decision by December 15th.

If you do not have benefits but want to explore this option for the future, there is no set date you must begin your medical plan. If you prefer not to rush and want to begin benefits February 1 or March 1, that is an option as well.

Plan Designs

UnitedHealthcare has limited plan designs for members wishing to join an Association Health Plan (AHP).

However, you will have several options for:

  • PPO (offers in and out-of-network coverage)
  • EPO
  • HMO (offers only in-network coverage)
  • HSA (Health Savings Account) plans with PPO, EPO and HMO plans

There is no direct membership fee that you will pay to the North Texas Employer Health Plan Cooperative or the Collin County Cooperative, however you will see a .05% administration fee included on your monthly insurance invoice, as these organizations will be assisting with coordination of services.

Participating Counties

Your place of business must be located within one of these counties in order to participate. A P.O. Box is not sufficient.

Dallas, Denton, Archer, Navarro, Cooke, Montague, Palo Pinto, Tarrant, Parker, Clay, Rockwall, Hood, Somervell, Grayson, Wichita Falls, Kaufman, Wise, Johnson, Young, Erath, Jack, Ellis

Next Steps

Contact us to assist in your implementation of medical insurance benefits. Our agency is a top-rated firm located here in North Texas. We also provide a robust benefit administration platform at no cost to you.

Important Ruling
In March of 2019, the U.S. District Court for the District of Columbia (Senior Judge Bates) issued an unfavorable opinion in a lawsuit brought by eleven states and the District of Columbia, striking down the key provisions of the Department of Labor’s Association Health Plan (“AHP”) rule. The AHP rule expanded: (1) the range of associations that may offer AHPs to include many state and local chambers that had not previously been able to offer plans; and (2) the range of businesses that may participate in AHPs to include sole proprietorships. Judge Bates concluded that the DOL exceeded its authority under the Employee Retirement Income Security Act of 1974 (“ERISA”) in promulgating this rule. The U.S. Chamber led a coalition of business groups in filing an amicus curiae brief in support of the AHP rule. The decision is a major loss for many state and local chambers that are already offering (or planning to offer) AHPs under the DOL’s rule. Many state and local chambers spent significant resources (money and time) on AHP offerings, and many of their members and, in turn, their families and employees, were either covered by AHPs or were expecting to be covered in the near future. Judge Bates’ decision takes effect immediately—unless and until it is stayed (by either Judge Bates or a higher court). In this case, given that there may be thousands of individuals who have (or soon expect to have) new health insurance coverage under an AHP, there may be compelling reasons for a stay. Although Judge Bates’ decision does not, by its own terms, invalidate any AHPs already offered by state and local chambers, it does undermine the legality of insurance coverage under those plans. This creates significant uncertainty for state and local chambers, for insurance companies collaborating with chambers to offer insurance coverage, and most importantly for many employees and their families covered by such plans. The U.S. Chamber believes the decision should be stayed, and we are taking steps to support the Department of Labor in the event that it decides to seek a stay and to appeal. We will keep members apprised of developments in this important litigation.


Submit a Comment

Your email address will not be published. Required fields are marked *