Associated Self-Funded Health Benefit Plan Coverage Act; create.

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To: State Affairs
MISSISSIPPI LEGISLATURE REGULAR SESSION 2026

By: Representatives Burch, McMillan

HOUSE BILL NO. 1236

AN ACT TO CREATE THE ASSOCIATION SELF-FUNDED HEALTH BENEFIT 1
PLAN COVERAGE ACT; TO DEFINE CERTAIN TERMS; TO AUTHORIZE AN 2
ASSOCIATION IN MISSISSIPPI TO PURCHASE HOSPITAL, SURGICAL AND 3
MEDICAL EXPENSE BENEFITS COVERAGE FROM A SELF-FUNDED ASSOCIATION 4
PLAN SUBJECT TO THE JURISDICTION OF ANOTHER STATE INSURANCE 5
DEPARTMENT OR THE FEDERAL GOVERNMENT; TO EXEMPT SUCH PLANS SUBJECT 6
TO THE JURISDICTION OF ANOTHER STATE OR THE FEDERAL GOVERNMENT 7
FROM THE INSURANCE LAWS OF THIS STATE AND REGULATIONS OF THE 8
DEPARTMENT OF INSURANCE UPON DEMONSTRATING TO THE COMMISSIONER OF 9
INSURANCE THAT CERTAIN REQUIREMENTS HAVE BEEN MET; TO REQUIRE 10
WRITTEN NOTICE TO BE PROVIDED TO PLAN PARTICIPANTS AND PROSPECTIVE 11
PURCHASERS THAT THE PLAN IS NOT REGULATED BY MISSISSIPPI LAW; TO 12
AUTHORIZE THE COMMISSIONER TO RETAIN PROFESSIONALS TO ASSIST IN 13
REVIEWING A PLAN'S REQUEST TO BE EXEMPT FROM STATE INSURANCE LAWS 14
AND REGULATIONS; TO REQUIRE SUCH PLANS TO DESIGNATE THE 15
COMMISSIONER AS ITS AGENT FOR SERVICE OF PROCESS IN MISSISSIPPI; 16
TO AUTHORIZE THE COMMISSIONER TO ADOPT RULES AND REGULATIONS TO 17
CARRY OUT THE PROVISIONS OF THE ACT; TO AMEND SECTION 83-5-3, 18
MISSISSIPPI CODE OF 1972, IN CONFORMITY TO THE PROVISIONS OF THIS 19
ACT; AND FOR RELATED PURPOSES. 20
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI: 21
SECTION 1. Sections 1 through 15 of this act shall be known 22
and may be cited as the "Association Self-Funded Health Benefit 23
Plan Coverage Act." 24
SECTION 2. It is the purpose and intent of the Association 25
Self-Funded Health Benefit Plan Coverage Act to provide additional 26
group health benefit plan coverage options to associations located 27
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in the State of Mississippi by allowing their members to purchase 28
coverage from self-funded association plans that are subject to 29
the jurisdiction of another state insurance department or the 30
federal government. 31
SECTION 3. As used in this act, the following words and 32
phrases have the meanings provided in this section unless the 33
context clearly indicates otherwise: 34
(a) "Association" means an association that works to 35
unite, support, and represent fire service professionals across 36
the State of Mississippi, and to strengthen the fire service, 37
promote safety, and enhance the delivery of emergency services to 38
the people of Mississippi. 39
(b) "Association self-funded health benefit plan" means 40
a self-funded health benefit plan established in its domiciliary 41
jurisdiction for the members of an association to provide group 42
hospital, surgical or medical expense benefits to association 43
members, including dependents. 44
(c) "Commissioner of Insurance" or "commissioner" means 45
the Commissioner of Insurance of the State of Mississippi. 46
(d) "Fully insured association health benefit plan" 47
means an association health benefit plan that provides group 48
coverage for hospital, surgical or medical expense benefits, all 49
of which are guaranteed under a contract or policy of insurance 50
issued by an insurer authorized to do business in this state. 51
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SECTION 4. (1) Except as otherwise expressly provided in 52
this act, the provisions of Title 83, Mississippi Code of 1972, do 53
not apply to an association self-funded health benefit plan that 54
provides group coverage for hospital, surgical or medical expense 55
benefits if the plan can demonstrate, to the satisfaction of the 56
Commissioner of Insurance, that the plan is subject to the 57
jurisdiction of another state insurance department or the federal 58
government by providing the commissioner with the appropriate 59
certificate, license or written authorization issued by the 60
governmental agency that permits or otherwise qualifies the plan 61
to provide group coverage for hospital, surgical or medical 62
expense benefits. 63
(2) In addition to any other requirements set forth in this 64
act, in order to be eligible to provide association group 65
hospital, surgical or medical expense benefits coverage in this 66
state and to qualify for the exemption from the provisions of 67
Title 83, Mississippi Code of 1972, authorized under subsection 68
(1) of this section, an association self-funded health benefit 69
plan must demonstrate to the satisfaction of the Commissioner of 70
Insurance the following: 71
(a) That the plan was established in its domiciliary 72
jurisdiction for the members of an association that has been 73
organized and maintained in good faith for a continuous period of 74
no less than three (3) years for purposes other than obtaining or 75
providing insurance; 76
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(b) That the plan will provide group coverage in this 77
state only through an association, which association has been 78
organized and maintained in this state in good faith for a 79
continuous period of no less than three (3) years for purposes 80
other than obtaining or providing insurance; 81
(c) That the plan is in compliance with applicable laws 82
in its domiciliary jurisdiction and any applicable requirements 83
under the Employee Retirement Income Security Act of 1974 84
addressing coverage, financial and reserve requirements; 85
(d) That the rates are not inadequate, excessive or 86
unfairly discriminatory and are appropriate for the classes of 87
risks for which they have been computed; 88
(e) That the plan is being operated in accordance with 89
sound actuarial principles and is designed to provide sufficient 90
revenues to pay current and future liabilities; 91
(f) That the plan is neither offered nor advertised to 92
the public generally; 93
(g) That the plan is required under the laws of its 94
domiciliary jurisdiction to maintain excess insurance with a 95
retention level determined in accordance with sound actuarial 96
principles; 97
(h) That the plan is required under the laws of its 98
domiciliary jurisdiction to establish and maintain appropriate 99
loss reserves determined in accordance with sound actuarial 100
principles; and 101
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(i) That the plan is a nonprofit organization. 102
(3) Upon demonstrating to the satisfaction of the 103
commissioner that the association self-funded health benefit plan 104
is in compliance with this act, the plan must be recognized as 105
being exempt from the provisions of Title 83, Mississippi Code of 106
1972, and is not subject to regulation by the Mississippi 107
Department of Insurance. 108
(4) On or before February 15 of each year following the year 109
in which an association self-funded health benefit plan receives 110
an initial exemption under this section from the provisions of 111
Title 83, Mississippi Code of 1972, the plan shall certify to the 112
commissioner that the plan continues to meet the eligibility 113
requirements prescribed in this act. Failure to meet and maintain 114
the eligibility requirements set forth in this act is grounds for 115
denial, suspension or revocation of the plan's exemption from the 116
provisions of Title 83, Mississippi Code of 1972, and the plan's 117
eligibility to provide group health benefit coverage in this 118
state. 119
SECTION 5. A person who participates in an association 120
self-funded health benefit plan in Mississippi authorized under 121
this act must be provided written notice that the plan is not 122
regulated by the Mississippi Department of Insurance, and every 123
purchaser or prospective purchaser must be provided written notice 124
that the person's benefit plan is not otherwise regulated under 125
the laws of this state. 126
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SECTION 6. A purchaser or prospective purchaser of coverage 127
under an association self-funded health benefit plan authorized 128
under this act must be provided written notice that the benefit 129
plan is not covered by the Mississippi Life and Health Insurance 130
Guaranty Association created under Section 83-23-211. 131
SECTION 7. A purchaser or prospective purchaser of coverage 132
under an association self-funded health benefit plan authorized 133
under this act must be provided written notice that neither the 134
costs of the plan, benefits nor the benefit plan are regulated by 135
the Mississippi Department of Insurance. 136
SECTION 8. A person in this state is eligible for coverage 137
under an association self-funded health benefit plan if the 138
individual is a member of an association, including a dependent of 139
the individual as defined under the terms of the plan. 140
SECTION 9. This act does not apply to a fully insured 141
association health benefit plan or to an association self-funded 142
health benefit plan that is exempt from state insurance regulation 143
in accordance with the provisions of the Employee Retirement 144
Income Security Act of 1974. 145
SECTION 10. This act does not preclude an association from 146
engaging an insurance producer licensed to sell health insurance 147
in this state for the purposes of reviewing and considering a 148
group health plan offered to an association under this act. 149
SECTION 11. When reviewing an association self-funded health 150
benefit plan's request for a determination by the Commissioner of 151
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Insurance whether the plan is exempt from the provisions of Title 152
83, Mississippi Code of 1972, and is authorized to provide group 153
health benefit coverage through an association in this state, the 154
commissioner may retain attorneys, actuaries, certified public 155
accountants or other professionals and specialists to assist in 156
completing the review, the reasonable cost of which must be borne 157
by the plan that requested the determination. 158
SECTION 12. A third-party administrator administering an 159
association self-funded health benefit plan in this state must be 160
licensed under Chapter 18, Title 83, Mississippi Code of 1972. 161
SECTION 13. An association self-funded health benefit plan 162
providing coverage in this state pursuant to this act must 163
designate the commissioner as its agent solely for the purpose of 164
receiving service of legal documents or process, for which a 165
filing fee will be determined by the commissioner. 166
SECTION 14. An order issued by a United States District 167
Court enjoining an association self-funded health benefit plan 168
from operating in one or more states or in a territory or 169
possession of the United States upon finding that the group is in 170
hazardous financial condition or financially impaired condition is 171
enforceable in the courts of this state. 172
SECTION 15. The commissioner may adopt such rules and 173
regulations as may be necessary to carry out the provisions of 174
this act. 175
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SECTION 16. Section 83-5-3, Mississippi Code of 1972, is 176
amended as follows: 177
83-5-3. (1) Except as otherwise provided in subsection (2) 178
of this section, every insurance company, foreign or domestic, 179
that qualifies to do business in the State of Mississippi shall be 180
required to execute an agreement to be bound by the statute laws 181
of the State of Mississippi pertaining to the periods of 182
limitation prescribed by the statute law of this state. 183
The insurance commissioner is hereby required, as a condition 184
precedent to authorizing any insurance company to qualify and 185
operate under the laws of this state or to do business in this 186
state, to require said companies to execute an agreement binding 187
said company to conform to and to be bound and regulated by the 188
statute laws of this jurisdiction as defined in the first 189
paragraph. 190
For purposes of the administration of this section, insurance 191
companies shall consist of all types of insurance companies, both 192
domestic and foreign, that operate in this jurisdiction, including 193
stock companies, mutuals, and fraternal societies and 194
organizations when such fraternal society or organization engages 195
in the insuring of its members or other persons. 196
(2) This section does not apply to an association 197
self-funded health benefit plan exempt from the provisions of 198
Title 83, Mississippi Code of 1972, under Sections 1 through 15 of 199
this act. 200
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ST: Associated Self-Funded Health Benefit Plan
Coverage Act; create.
SECTION 17. This act shall take effect and be in force from 201
and after July 1, 2026. 202