I haven't paid much attention to association plans in a while, but many of them used a master trust incorporated into the association plan. The trust was the policyholder filed in a specific state, say Texas. As long as the benefits and wording complied with TX requirements that was all that mattered.
The association plan could be sold in other states under the deemer provisions without having to file in each state. Companies and individuals that bought coverage through the association were subscribers and were issued a certificate.
The association plan - trust arrangement was great for marching across state lines. The vulnerability lies in the fact that when the master trust is dissolved, or loses their issuing carrier without a replacement, the coverage went away.
At least one Medigap carrier (can't recall which one) uses a trust/association for their product. It has the same vulnerability that the association health plans had in the past.
Many of these trusts ran quite successfully for years. Issuing carriers came and went but the block remained viable. Benefits usually did not change with a new carrier but rates often did. One nice thing (from a certificate holder perspective) was if carrier A wanted a 20% rate increase but carrier B was willing to assume the risk at 10% above current rates those who have coverage were "winners".
They kept their plan, the benefits didn't change, same people (the TPA administering the trust) paid claims and rates were stable over time. But only as long as the folks running the trust did a proper job of managing the plan.
The association plan could be sold in other states under the deemer provisions without having to file in each state. Companies and individuals that bought coverage through the association were subscribers and were issued a certificate.
The association plan - trust arrangement was great for marching across state lines. The vulnerability lies in the fact that when the master trust is dissolved, or loses their issuing carrier without a replacement, the coverage went away.
At least one Medigap carrier (can't recall which one) uses a trust/association for their product. It has the same vulnerability that the association health plans had in the past.
Many of these trusts ran quite successfully for years. Issuing carriers came and went but the block remained viable. Benefits usually did not change with a new carrier but rates often did. One nice thing (from a certificate holder perspective) was if carrier A wanted a 20% rate increase but carrier B was willing to assume the risk at 10% above current rates those who have coverage were "winners".
They kept their plan, the benefits didn't change, same people (the TPA administering the trust) paid claims and rates were stable over time. But only as long as the folks running the trust did a proper job of managing the plan.