NAR Association Health Plan Policy
NAR remains committed to vigorously engaging insurers and pursuing nationwide and/or regional options that offer additional health insurance options to members.
Association Health Plans (AHP)
On June 21, 2018, the U.S. Department of Labor (DOL) issued a new rule opening the door for small employers and self-employed individuals, including real estate professionals, to participate in Association Health Plans (AHPs). However, that rule was invalidated by a federal court in 2019, resulting in the AHPs created under the 2018 regulation to be discontinued.
What is an AHP?
AHPs are "large group" plans that tend to offer better coverage options at lower cost than the "individual" and "small group" insurance markets. Currently many NAR members typically purchase their health coverage in the individual or small group markets, which tend to have higher costs and limited options.
What is NAR Doing?
NAR continues to evaluate whether and how AHPs can offer health insurance solutions to members and their families. NAR has conducted extensive research through surveys and nationwide focus groups. NAR has also worked with outside health insurance consultants connected to large insurance companies evaluating AHPs to better understand options and secure favorable state regulatory environments. These efforts will continue, but insurance companies have yet to show an appetite for offering a national AHP to NAR or any other trade association given the ongoing legal challenges and state regulatory barriers. There has been significant progress, but NAR still must take a number of concrete steps to find workable solutions.
A number of state and local REALTOR® associations in the past have pursued health insurance solutions for members through AHPs, which NAR has supported. Successful state and local implementation could serve as an example for insurers and could set the stage for a national plan down the road.
NAR also helped found a broad multi-industry to promote and support the DOL final rule – the Coalition to Protect and Promote AHPs. The purpose of the Coalition is to unite industry efforts and work with federal and state regulators to address state concerns while preserving the flexibility for access to AHPs. As part of the coalition and on an individual basis, NAR will continue to advocate for expanding our membership’s access to comprehensive and quality health insurance options at the federal, regional, state, and local levels.
Shortly after the DOL issued the AHP rule, more than a dozen states filed suit to overturn the rule. Many of the states also issued conflicting legal guidance. This combination created uncertainty for insurance providers, leading to discontinuation of many AHPs for self-employed individuals.
On March 28, 2019, the U.S. District Court for the District of Columbia held in favor of the AGs opposing the rule, striking down essential provisions allowing self-employed individuals to participate in an AHP and prohibiting “unrelated” employers from banding together to sponsor an AHP. Learn more about the court decision.
On May 31, 2019, the Department of Justice filed an appeal in the case. Pending the outcome of the appeal, the Department of Labor issued a series of “question and answer” guidance on the court ruling to address outstanding questions related to AHP operations (see NAR summary).
On June 7, 2019, NAR filed an amicus brief (friend of the court brief) in support of DOL’s Appeal. In addition to supporting the fight against the court ruling, including alongside fellow members of the Coalition to Protect and Promote AHPs, over 200 state and local REALTOR® associations also expressed support for AHPs and NAR’s defense of the rule.
Oral arguments in the case were held in November of 2019 and a decision is still pending.
Where Are We Now?
The uncertainty in the legal landscape has prevented, at this time, a national insurance provider from stepping forward to offer a nationwide AHP option to NAR or any national trade association. Until the legal uncertainty is resolved by Federal courts, or more states issue rules providing market stability, insurance companies are unlikely to develop acceptable nationwide AHPs.
In the meantime, NAR continues met with the Department of Labor supporting the benefits of AHPs that gives self-employed individuals access to more affordable insurance options. NAR has also urged the Secretary to collaborate with the Department of Health and Human Services to ensure that federal law should not preempt states making statutory changes to allow for AHPs while the federal litigation is resolved.
NAR remains invested in state and local association efforts to pursue AHPs and has provided resources for Associations to use as they investigate and seek to implement an AHP in their area.