"One repeated consideration that characterizes the rule is the Department's effort to ensure that a group or association has a 'sufficiently close economic or representational nexus to the employers and employees that participate in the plan.' Where an employment relationship to the association does not exist, the only connection between a member employer and the association is the health coverage itself. When that is the case, courts have held that the relationship is more similar to a relationship between an employer and a state-regulated private insurer, which would be subject to many more consumer protections. The Department asserts throughout the rule that it has adequately addressed concerns about these types of arrangements masquerading as AHPs."  MORE >>