In North Carolina, the Restaurant & Hospitality Association Benefit Trust formed to allow workers in the service industry to band together and for an "association" to negotiate more affordable health plans.
In June of 2018 the Department of Labor created a rule to expand access to association insurance plans. The expansion of “association plans” can increase the leverage of uninsured workers while providing competition with ACA plans.
Association plans allow workers who are self employed or employed by a small businesses to band together and obtain affordable health insurance as a large block, much like a large corporation. The large block increases the negotiating power, thus decreasing premiums. Individuals and small business can join an association as long as they have 99 employees or less. Associations can form around common industry or geography. The plans eschew basic ACA requirements like essential benefits. They also allow some flexibility in pricing up premiums due to gender and age.
With the creation of Restaurant & Hospitality Association Benefit Trust, hospitality workers in North Carolina will have an opportunity to access health insurance through an association. The Restaurant & Hospitality Association Benefit Trust looks to insure some of the 432,000 restaurant and hospitality workers in North Carolina. Many of these workers are high risk, faced with high premiums and opt-out of having health insurance altogether. The Restaurant & Hospitality Association Benefit Trust is backed by United Health. It remains to be seen whether association health plans offer significant cost savings over ACA plans.
If the Restaurant & Hospitality Association Benefit Trust in North Carolina succeeds, look for more participation from other states.