Association Self-Funded Health Benefit Plan Act; enact., the official text

MISSISSIPPI
LEGISLATURE

2026
Regular Session

To:
Insurance

By:
Senator(s) Michel, Wiggins, Blackmon, Hickman, England, Turner-Ford, Hopson,
Barrett, Suber

Senate Bill 2704

(As Sent to Governor)

AN ACT TO ENACT THE ASSOCIATION SELF-FUNDED HEALTH BENEFIT
PLAN COVERAGE ACT; TO PROVIDE ADDITIONAL GROUP HEALTH BENEFIT PLAN COVERAGE
OPTIONS TO PROFESSIONAL ASSOCIATIONS AND TRADE ASSOCIATIONS LOCATED IN THE
STATE OF MISSISSIPPI BY ALLOWING THEIR MEMBERS TO PURCHASE COVERAGE FROM SELF-FUNDED
ASSOCIATION PLANS THAT ARE SUBJECT TO THE JURISDICTION OF ANOTHER STATE
INSURANCE DEPARTMENT OR THE FEDERAL GOVERNMENT; TO AUTHORIZE THE MISSISSIPPI
COMMISSIONER OF INSURANCE TO ISSUE REGULATIONS TO IMPLEMENT THIS ACT; AND FOR
RELATED PURPOSES.

BE IT ENACTED BY THE LEGISLATURE OF THE
STATE OF MISSISSIPPI:

SECTION 1.
This act may be known and shall be cited as the "Association Self-Funded
Health Benefit Plan Coverage Act."

SECTION 2.  It
is the purpose and intent of the Association Self-Funded Health Benefit Plan
Coverage Act to provide additional group health benefit plan coverage options
to professional associations and trade associations located in the State of
Mississippi by allowing their members to purchase coverage from self-funded
association plans that are subject to the jurisdiction of another state
insurance department or the federal government.

SECTION 3.  As
used in this act, the following words have the meanings as defined in this
section unless the context clearly indicates otherwise:

(a)  "Association
self-funded health benefit plan" means a self-funded health benefit plan
established in its domiciliary jurisdiction for the members of a professional
association or trade association to provide group hospital, surgical or medical
expense benefits to association members and their employees, including
dependents.

(b)  "Commissioner
or Commissioner of Insurance" shall mean the Commissioner of Insurance of
the State of Mississippi.

(c)  "Fully
insured association health benefit plan" means an association health
benefit plan which provides group coverage for hospital, surgical or medical
expense benefits, all of which are guaranteed under a contract or policy of
insurance issued by an insurer authorized to do business in this state.

(d)  "Professional
association" means member employers and individual members who are self-employed,
who are of the same type of profession, such as lawyers, physicians, dentists,
accountants, or architects; but is not limited to those professions.  However,
the profession must be one that is recognized by the required licensing agency.

(e)  "Trade
association" means member employers and individual members who are self-employed,
who are in the same type of trade, such as plumbers or electricians; and any
others that are trade designations as recognized by the required licensing
agency.

SECTION 4.
(1)  Except as expressly provided in this act, the insurance laws of the State
of Mississippi, as set forth in Title 83 of the Mississippi Code, shall not
apply to any association self-funded health benefit plan that provides group
coverage for hospital, surgical or medical expense benefits if the plan can
demonstrate to the satisfaction of the Commissioner of Insurance that the plan
is subject to the jurisdiction of another state insurance department or the
federal government by providing the commissioner with the appropriate certificate,
license or written authorization issued by the other governmental agency that
permits or otherwise qualifies the plan to provide group coverage for hospital,
surgical or medical expense benefits.

(2)  In addition to any
other requirements as set forth in this act, to be eligible to provide
association group hospital, surgical or medical expense benefit coverage in
this state, and to qualify for the exemption from Title 83 of the Mississippi
Code as set forth in this section, an association self-funded health benefit
plan shall demonstrate to the satisfaction of the commissioner the following:

(a)  That the plan was
established in its domiciliary jurisdiction for the members of a professional
association or trade association that has been organized and maintained in good
faith for a continuous period of three (3) years for purposes other than that of
obtaining or providing insurance.

(b)  That the plan will
only provide group coverage in this state through an association whose members
are in the same trade or profession and that has been organized and maintained
in this state in good faith for a continuous period of three (3) years for
purposes other than that of obtaining or providing insurance.

(c)  That the plan is
in compliance with applicable laws in its domiciliary jurisdiction and any
applicable requirements under the Employee Retirement Income Security Act of
1974, addressing coverage, financial and reserve requirements.

(d)  That the rates are
not inadequate, excessive, or unfairly discriminatory and are appropriate for
the classes of risks for which they have been computed.

(e)  That the plan is
being operated in accordance with sound actuarial principles and is designed to
provide sufficient revenues to pay current and future liabilities.

(f)  That the plan is
neither offered nor advertised to the public generally.

(g)  That the plan is
required under the laws of its domiciliary jurisdiction to maintain excess
insurance with a retention level determined in accordance with sound actuarial
principles.

(h)  That the plan is
required under the laws of its domiciliary jurisdiction to establish and
maintain appropriate loss reserves determined in accordance with sound
actuarial principles.

(i)  That the plan is a
nonprofit organization.

(i)  Upon
demonstrating to the satisfaction of the commissioner that the Association Self-Funded
Health Benefit Plan is in compliance with the provisions of this act, the plan
shall be exempt from all other provisions of Title 83 of the Mississippi Code
and shall not be regulated by the Mississippi Insurance Department.

(ii)  An
association self-funded health benefit plan that receives an initial exemption
under this section from Title 83 of the Mississippi Code shall certify to the
commissioner each year thereafter, on or before February 15th, that the plan
continues to meet the eligibility requirements contained in this act.  Failure
to meet and maintain the eligibility requirements set forth in this act shall
be grounds for denial, suspension or revocation of the plan's exemption from
Title 83 of the Mississippi Code and its eligibility to provide group health
benefit coverage in this state.

SECTION 5.
Any person who participates in an association self-funded health benefit plan
in Mississippi as described in this act shall be provided written notice that
the plan is not regulated by the Mississippi Insurance Department and every
purchaser or prospective purchaser shall be provided written notice that the
person's benefit plan is not otherwise regulated under Mississippi law.

SECTION 6.
Any purchaser or prospective purchaser of coverage under an association self-funded
health benefit plan as described in this act shall be provided written notice
that the benefit plan is not covered by the Mississippi Life and Health
Insurance Guaranty Association.

SECTION 7.
Any purchaser or prospective purchaser of coverage under an association self-funded
health benefit plan as described in this act shall be provided written notice
that neither the costs of the plan, benefits, nor the benefit plan are
regulated by the Mississippi Insurance Department.

SECTION 8.
Individuals in this state eligible for coverage under an association self-funded
health benefit plan shall be an employee who is covered by an association plan
in which an employer is participating or a self-employed individual who is
covered by an association plan, including a dependent of an employee or self-employed
individual as defined under the terms of the plan.

SECTION 9.
This act shall not apply to a fully insured association health benefit plan or
to an association self-funded health benefit plan that is exempt from state
insurance regulation in accordance with the provisions of the Employee
Retirement Income Security Act of 1974.

SECTION 10.
Nothing in this act shall preclude an association from engaging an insurance
producer licensed to sell health insurance in this state for the purposes of
reviewing and considering any group health plan offered to an association under
this act.

SECTION 11.
When reviewing an association self-funded health benefit plan's request for a
determination by the commissioner whether the plan is exempt from Title 83 of
the Mississippi Code and is authorized under this act to provide group health
benefit coverage through a professional or trade association in this state, the
commissioner may retain attorneys, actuaries, certified public accountants or
other professionals and specialists to assist in completing the review, the
reasonable cost of which shall be borne by the plan which requested the
determination.

SECTION 12.
Any third-party administrator administering an association self-funded health
benefit plan in this state shall be licensed pursuant to the provisions of
Section 83-18-1 et seq., Mississippi Code of 1972.

SECTION 13.
An association self-funded health benefit plan providing coverage in this state
pursuant to this act shall designate the commissioner as its agent solely for
the purpose of receiving service of legal documents or process, for which a
filing fee shall be determined by the commissioner.

SECTION 14.
An order issued by any District Court of the United States enjoining an
association self-funded health benefit plan from operating in any state (or in
all states or in any territory or possession of the United States) upon a
finding that such a group is in hazardous financial condition or financially
impaired condition shall be enforceable in the courts of this state.

SECTION 15.
The commissioner may adopt such rules and regulations as shall be necessary to
carry out the provisions of this act.

SECTION 16.  This act
shall take effect and be in force from and after October 1, 2026.