CHOICE Arrangement Act
What changed between versions
Title I (Association Health Plans Act) amends ERISA to allow groups or associations of employers - including self-employed individuals - to be treated as a single employer for group health plan purposes, provided they meet requirements such as having at least 51 aggregated employees, existing for at least 2 years, being formed in good faith for non-medical purposes, and having a governing board that is at least 75% employer members.
Title VI adds a non-binding Sense of Congress resolution stating that healthcare freedom is the future, that coverage is not care, and that patients and doctors should make healthcare decisions rather than government or insurance bureaucrats.
The bill's short title was changed from the 'Custom Health Option and Individual Care Expense Arrangement Act or the CHOICE Arrangement Act' to simply the 'Association Health Plans Act,' reflecting the new primary focus of the legislation.
New definition of 'self-employed individual' for association health plan purposes: no common law employees, ownership in a trade or business, earns wages or self-employment income from it, and works at least 10 hours per week or 40 hours per month providing personal services to that business.
Association health plans may use modified community rating for base premiums while adjusting contribution rates by employer risk profile. Plans made up solely of self-employed individuals must treat all members as a single risk pool and charge the same premium rate to each participant.
Title IV (Small Business Flexibility Act) requires the Secretary to notify employers within 1 year of enactment about tax-advantaged flexible health insurance benefits, with initial focus on small businesses in rural areas, including individual contribution HRAs, qualified small employer HRAs, and the small employer health insurance credit.
Title III (Self-Insurance Protection Act) amends ERISA to exclude stop-loss insurance from the definition of 'health insurance coverage' and preempts state laws that prevent group health plans from purchasing stop-loss coverage to protect against excess claims losses.
Title V reduces the Prevention and Public Health Fund from $1.3 billion for FY2024 to $1.055 billion for FY2024, while keeping FY2025 at $1.3 billion - a reduction of approximately $245 million.
The original CHOICE Arrangement Act content was renumbered from section 2 to section 202 under new Title II. Minor typo corrections were made (e.g., 'designated' changed to 'designate', 'parts A and B' changed to 'part A and B').
