- CHOICE Arrangements (formerly ICHRAs) allow employees to choose individual health plans that best meet their needs, providing flexibility and potentially lowering costs through more tailored coverage. They also reduce administrative burdens on employers. The CHOICE Act (H.R. 5463/S. 2875) would codify and expand CHOICE arrangements, simplify their administration, and allow self-employed business owners to access tax-favored health reimbursement arrangements.
- AHPs are one option for small businesses to offer more affordable insurance to employees. AHPs allow small businesses to pool resources and leverage purchasing power like larger groups. The Association Health Plan Act (H.R. 2528/S. 1847) will expand small businesses’ ability to participate in AHPs and improve existing regulations to allow industry and non-industry-based small businesses, including self-employed individuals, to establish an AHP.
- Expanding Health Savings Account(HSA) access. Currently, HSAs cannot be used to pay for small group health insurance premiums, limiting their usefulness for small employers and their workers. With insurance premiums skyrocketing, allowing them to be paid by an HSA would give small businesses greater flexibility to design benefits that fit their workforce and budget.
- Allow health insurance products, like Short-Term, Limited-Duration Insurance (STLDI) plans, to be available for extended time periods. STLDI plans offer catastrophic-type coverage to individuals. These plans have broader provider networks and are much less costly than a traditional small group plan. The COMPETE Act (S. 3418) would amend the Public Health Service Act to extend the maximum duration of STLDI and include a renewal guarantee provision that allows consumers to purchase STLDI plans for an extended period.
- Protect small businesses’ access to stop-loss insurance. Self-insurance can offer employers more flexibility, leading to more affordable coverage. Stop-loss insurance enables self-insured employers to mitigate risks, protecting employers and employees from catastrophic losses. Thirty-eight percent of small firms reported offering health benefits through a level-funded plan in 2022. Level-funded plans provide small employers with potential cost savings, predictability, and customization. Congress must enact the Self-Insurance Protection Act (H.R. 2571) to protect and expand small businesses’ access to stop-loss insurance.
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