IB 
Union Calendar No. 357 
119TH CONGRESS 
1ST SESSION H. R. 2528 
[Report No. 119–409] 
To amend the Employee Retirement Income Security Act of 1974 to clarify 
the treatment of certain association health plans as employers, and 
for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
APRIL 1, 2025 
Mr. WALBERG (for himself, Mr. ALLEN, Mr. ONDER, Mr. CRENSHAW, Mrs. 
BICE, Mr. KILEY of California, Mr. GROTHMAN, Mr. MACKENZIE, and 
Mr. HUIZENGA) introduced the following bill; which was referred to the 
Committee on Education and Workforce 
DECEMBER 15, 2025 
Additional sponsors: Mr. OWENS, Mr. HARRIS of North Carolina, Mr. THOMP-
SON of Pennsylvania, Mr. HILL of Arkansas, Mr. SMITH of Nebraska, 
Mr. BIGGS of Arizona, Mr. CUELLAR, Mr. VAN DREW, Mr. WEBER of 
Texas, Mrs. FISCHBACH, Mr. HUNT, Mr. GOLDMAN of Texas, Mr. 
GOSAR, Mr. MESSMER, Mr. SMITH of New Jersey, Mr. CISCOMANI, Mr. 
HAMADEH of Arizona, Mr. BISHOP, Mr. MEUSER, Mr. BARR, Mr. DUNN 
of Florida, Mr. CALVERT, Mr. FITZGERALD, and Mr. SCHWEIKERT 
DECEMBER 15, 2025 
Reported with an amendment, committed to the Committee of the Whole 
House on the State of the Union, and ordered to be printed 
[Strike out all after the enacting clause and insert the part printed in italic] 
[For text of introduced bill, see copy of bill as introduced on April 1, 2025] 
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A BILL 
To amend the Employee Retirement Income Security Act 
of 1974 to clarify the treatment of certain association 
health plans as employers, and for other purposes. 
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Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Association Health 
Plans Act’’. 
SEC. 2. TREATMENT OF GROUP OR ASSOCIATION OF EM-
PLOYERS. 
(a) IN GENERAL.—Section 3(5) of the Employee Re-
tirement Income Security Act of 1974 (29 U.S.C. 1002(5)) 
is amended— 
(1) by striking ‘‘The term’’ and inserting ‘‘(A) 
The term’’; and 
(2) by adding at the end the following: 
‘‘(B) For purposes of subparagraph (A), a group or 
association of employers shall be treated as an ‘employer’ 
solely for purposes of sponsoring a group health plan, re-
gardless of whether the employers composing such group or 
association are in the same industry, trade, or profession, 
if such group or association— 
‘‘(i)(I) has established and maintains an em-
ployee welfare benefit plan that is a group health 
plan (as defined in section 733(a)(1)); 
‘‘(II) provides coverage under such plan to at 
least 51 employees after all of the employees employed 
by all of the employer members of such group or asso-
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ciation have been aggregated and counted together as 
described in subparagraph (D); 
‘‘(III) has been actively in existence for at least 
2 years; 
‘‘(IV) has been formed and maintained in good 
faith for purposes other than providing medical care 
(as defined in section 733(a)(2)) through the purchase 
of insurance or otherwise; 
‘‘(V) does not condition membership in the group 
or association on any health status-related factor (as 
described in section 702(a)(1)) relating to any indi-
vidual; 
‘‘(VI) makes coverage under such plan available 
to all employer members of such group or association 
regardless of any health status-related factor (as de-
scribed in section 702(a)(1)) relating to such em-
ployer members; 
‘‘(VII) does not provide coverage under such plan 
to any individual other than an employee of an em-
ployer member of such group or association; 
‘‘(VIII) has established a governing board with 
by-laws or other similar indications of formality to 
manage and operate such plan in both form and sub-
stance, of which at least 75 percent of the board mem-
bers shall be made up of employer members of such 
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group or association participating in the plan that 
are duly elected by each participating employer mem-
ber casting 1 vote during a scheduled election; and 
‘‘(IX) is not a health insurance issuer (as defined 
in section 733(b)(2)), and is not owned or controlled 
by such a health insurance issuer or by a subsidiary 
or affiliate of such a health insurance issuer, other 
than to the extent such a health insurance issuer may 
participate in the group or association as a member; 
‘‘(ii) is structured in good faith with any set of 
criteria to qualify for such treatment in any advisory 
opinion issued prior to the date of enactment of the 
Association Health Plans Act; or 
‘‘(iii) meets any other set of criteria to qualify 
for such treatment that the Secretary by regulation 
may provide. 
‘‘(C)(i) For purposes of subparagraph (B), a self-em-
ployed individual shall be treated as— 
‘‘(I) an employer who may become a member of 
a group or association of employers; 
‘‘(II) an employee who may participate in an 
employee welfare benefit plan established and main-
tained by such group or association; and 
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‘‘(III) a participant of such plan subject to the 
eligibility determination and monitoring require-
ments set forth in clause (iii). 
‘‘(ii) For purposes of this subparagraph, the term ‘self- 
employed individual’ means an individual who— 
‘‘(I) does not have any common law employees; 
‘‘(II) has a bona fide ownership right in a trade 
or business, regardless of whether such trade or busi-
ness is incorporated or unincorporated; 
‘‘(III) earns wages (as defined in section 3121(a) 
of the Internal Revenue Code of 1986) or self-employ-
ment income (as defined in section 1402(b) of such 
Code) from such trade or business; and 
‘‘(IV) works at least 10 hours a week or 40 hours 
per month providing personal services to such trade 
or business. 
‘‘(iii) The board of a group or association of employers 
shall— 
‘‘(I) initially determine whether an individual 
meets the requirements under clause (ii) to be consid-
ered to a self-employed individual for the purposes of 
being treated as an— 
‘‘(aa) employer member of such group or as-
sociation (in accordance with clause (i)(I)); and 
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‘‘(bb) employee who may participate in the 
employee welfare benefit plan established and 
maintained by such group or association (in ac-
cordance with clause (i)(II)); 
‘‘(II) through reasonable monitoring procedures, 
periodically determine whether the individual con-
tinues to meet such requirements; and 
‘‘(III) if the board determines that an individual 
no longer meets such requirements, not make such 
plan coverage available to such individual (or de-
pendents thereof) for any plan year following the plan 
year during which the board makes such determina-
tion. If, subsequent to a determination that an indi-
vidual no longer meets such requirements, such indi-
vidual furnishes evidence of satisfying such require-
ments, such individual (and dependents thereof) shall 
be eligible to receive plan coverage. 
‘‘(D) For purposes of subparagraph (B), all of the em-
ployees (including self-employed individuals) employed by 
all of the employer members (including self-employed indi-
viduals) of a group or association of employers shall be— 
‘‘(i) treated as participants in a single plan 
multiple employer welfare arrangement; and 
‘‘(ii) aggregated and counted together for pur-
poses of any regulation of an employee welfare benefit 
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plan established and maintained by such group or as-
sociation.’’. 
(b) DETERMINATION OF EMPLOYER OR JOINT EM-
PLOYER STATUS.—The provision of employee welfare ben-
efit plan coverage by a group or association of employers 
shall not be construed as evidence for establishing an em-
ployer or joint employer relationship under any Federal or 
State law. 
SEC. 3. RULES APPLICABLE TO EMPLOYEE WELFARE BEN-
EFIT PLANS ESTABLISHED AND MAINTAINED 
BY A GROUP OR ASSOCIATION OF EMPLOY-
ERS. 
(a) IN GENERAL.—Part 7 of subtitle B of title I of 
the Employee Retirement Income Security Act of 1974 (29 
U.S.C. 1181, et seq.) is amended by adding at the end the 
following: 
‘‘SEC. 736. RULES APPLICABLE TO EMPLOYEE WELFARE 
BENEFIT PLANS ESTABLISHED AND MAIN-
TAINED BY A GROUP OR ASSOCIATION OF EM-
PLOYERS. 
‘‘(a) PREMIUM RATES FOR A GROUP OR ASSOCIATION 
OF EMPLOYERS.— 
‘‘(1)(A) In the case of an employee welfare ben-
efit plan established and maintained by a group or 
association of employers described in section 3(5)(B), 
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such plan may, to the extent not prohibited under 
State law— 
‘‘(i) establish base premium rates formed on 
an actuarially sound, modified community rat-
ing methodology that considers the pooling of all 
plan participant claims; and 
‘‘(ii) utilize the specific risk profile of each 
employer member of such group or association to 
determine contribution rates for each such em-
ployer member’s share of a premium by actuari-
ally adjusting above or below the established base 
premium rates. 
‘‘(B) For purposes of paragraph (1), the term 
‘employer member’ means— 
‘‘(i) an employer who is a member of such 
group or association of employers and employs 
at least 1 common law employee; or 
‘‘(ii) a group made up solely of self-em-
ployed individuals, within which all of the self- 
employed individual members of such group or 
association are aggregated together as a single 
employer member group, provided the group in-
cludes at least 20 self-employed individual mem-
bers. 
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‘‘(2) In the event a group or association is made 
up solely of self-employed individuals (and no em-
ployers with at least 1 common law employee are 
members of such group or association), the employee 
welfare benefit plan established by such group or asso-
ciation shall— 
‘‘(A) treat all self-employed individuals who 
are members of such group or association as a 
single risk pool; 
‘‘(B) pool all plan participant claims; and 
‘‘(C) charge each plan participant the same 
premium rate. 
‘‘(b) DISCRIMINATION AND PRE-EXISTING CONDITION 
PROTECTIONS.—An employee welfare benefit plan estab-
lished and maintained by a group or association of employ-
ers described in section 3(5)(B) shall be prohibited from— 
‘‘(1) establishing any rule for eligibility (includ-
ing continued eligibility) of any individual (includ-
ing an employee of an employer member or a self-em-
ployed individual, or a dependent of such employee or 
self-employed individual) to enroll for benefits under 
the terms of the plan that discriminates based on any 
health status-related factor that relates to such indi-
vidual (consistent with the rules under section 
702(a)(1)); 
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‘‘(2) requiring an individual (including an em-
ployee of an employer member or a self-employed in-
dividual, or a dependent of such employee or self-em-
ployed individual), as a condition of enrollment or 
continued enrollment under the plan, to pay a pre-
mium or contribution that is greater than the pre-
mium or contribution for a similarly situated indi-
vidual enrolled in the plan based on any health sta-
tus-related factor that relates to such individual (con-
sistent with the rules under section 702(b)(1)); and 
‘‘(3) denying coverage under such plan on the 
basis of a pre-existing condition (consistent with the 
rules under section 2704 of the Public Health Service 
Act).’’. 
(b) CLERICAL AMENDMENT.—The table of contents in 
section 1 of such Act is amended by inserting after the item 
relating to section 734 the following new items: 
‘‘Sec. 735. Standardized reporting format. 
‘‘Sec. 736. Rules applicable to employee welfare benefit plans established and 
maintained by a group or association of employers.’’. 
SEC. 4. RULE OF CONSTRUCTION. 
Nothing in this Act shall be construed to exempt a 
group health plan which is an employee welfare benefit plan 
offered through a group or association of employers from 
the requirements of part 7 of subtitle B of title I of the 
Employee Retirement Income Security Act of 1974 (29 
U.S.C. 1181 et. seq.), including the provisions of part A 
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Union Calendar No. 357 
119TH CONGRESS 
1ST SESSION 
H. R. 2528 
[Report No. 119–409] 
A BILL 
To amend the Employee Retirement Income Secu-
rity Act of 1974 to clarify the treatment of cer-
tain association health plans as employers, and 
for other purposes. 
DECEMBER 15, 2025 
Reported with an amendment, committed to the Com-
mittee of the Whole House on the State of the Union, 
and ordered to be printed 
VerDate Sep 11 2014 
20:40 Dec 15, 2025
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