Association Self-Funded Health Benefit Plan Act; enact.

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To: Insurance
MISSISSIPPI LEGISLATURE REGULAR SESSION 2026

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

SENATE BILL NO. 2704

AN ACT TO ENACT THE ASSOCIATION SELF-FUNDED HEALTH BENEFIT 1
PLAN COVERAGE ACT; TO PROVIDE ADDITIONAL GROUP HEALTH BENEFIT PLAN 2
COVERAGE OPTIONS TO PROFESSIONAL ASSOCIATIONS AND TRADE 3
ASSOCIATIONS LOCATED IN THE STATE OF MISSISSIPPI BY ALLOWING THEIR 4
MEMBERS TO PURCHASE COVERAGE FROM SELF-FUNDED ASSOCIATION PLANS 5
THAT ARE SUBJECT TO THE JURISDICTION OF ANOTHER STATE INSURANCE 6
DEPARTMENT OR THE FEDERAL GOVERNMENT; TO AUTHORIZE THE MISSISSIPPI 7
COMMISSIONER OF INSURANCE TO ISSUE REGULATIONS TO IMPLEMENT THIS 8
ACT; AND FOR RELATED PURPOSES. 9
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI: 10
SECTION 1. This act may be known and shall be cited as the 11
"Association Self-Funded Health Benefit Plan Coverage Act." 12
SECTION 2. It is the purpose and intent of the Association 13
Self-Funded Health Benefit Plan Coverage Act to provide additional 14
group health benefit plan coverage options to professional 15
associations and trade associations located in the State of 16
Mississippi by allowing their members to purchase coverage from 17
self-funded association plans that are subject to the jurisdiction 18
of another state insurance department or the federal government. 19
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SECTION 3. As used in this act, the following words have the 20
meanings as defined in this section unless the context clearly 21
indicates otherwise: 22
(a) "Association self-funded health benefit plan" means 23
a self-funded health benefit plan established in its domiciliary 24
jurisdiction for the members of a professional association or 25
trade association to provide group hospital, surgical or medical 26
expense benefits to association members and their employees, 27
including dependents. 28
(b) "Commissioner or Commissioner of Insurance" shall 29
mean the Commissioner of Insurance of the State of Mississippi. 30
(c) "Fully insured association health benefit plan" 31
means an association health benefit plan which provides group 32
coverage for hospital, surgical or medical expense benefits, all 33
of which are guaranteed under a contract or policy of insurance 34
issued by an insurer authorized to do business in this state. 35
(d) "Professional association" means member employers 36
and individual members who are self-employed, who are of the same 37
type of profession, such as lawyers, physicians, dentists, 38
accountants, or architects; but is not limited to those 39
professions. However, the profession must be one that is 40
recognized by the required licensing agency. 41
(e) "Trade association" means member employers and 42
individual members who are self-employed, who are in the same type 43
of trade, such as plumbers or electricians; and any others that 44
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are trade designations as recognized by the required licensing 45
agency. 46
SECTION 4. (1) Except as expressly provided in this act, 47
the insurance laws of the State of Mississippi, as set forth in 48
Title 83 of the Mississippi Code, shall not apply to any 49
association self-funded health benefit plan that provides group 50
coverage for hospital, surgical or medical expense benefits if the 51
plan can demonstrate to the satisfaction of the Commissioner of 52
Insurance that the plan is subject to the jurisdiction of another 53
state insurance department or the federal government by providing 54
the commissioner with the appropriate certificate, license or 55
written authorization issued by the other governmental agency that 56
permits or otherwise qualifies the plan to provide group coverage 57
for hospital, surgical or medical expense benefits. 58
(2) In addition to any other requirements as set forth in 59
this act, to be eligible to provide association group hospital, 60
surgical or medical expense benefit coverage in this state, and to 61
qualify for the exemption from Title 83 of the Mississippi Code as 62
set forth in this section, an association self-funded health 63
benefit plan shall demonstrate to the satisfaction of the 64
commissioner the following: 65
(a) That the plan was established in its domiciliary 66
jurisdiction for the members of a professional association or 67
trade association that has been organized and maintained in good 68
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faith for a continuous period of three (3) years for purposes 69
other than that of obtaining or providing insurance. 70
(b) That the plan will only provide group coverage in 71
this state through an association whose members are in the same 72
trade or profession and that has been organized and maintained in 73
this state in good faith for a continuous period of three (3) 74
years for purposes other than that of obtaining or providing 75
insurance. 76
(c) That the plan is in compliance with applicable laws 77
in its domiciliary jurisdiction and any applicable requirements 78
under the Employee Retirement Income Security Act of 1974, 79
addressing coverage, financial and reserve requirements. 80
(d) That the rates are not inadequate, excessive, or 81
unfairly discriminatory and are appropriate for the classes of 82
risks for which they have been computed. 83
(e) That the plan is being operated in accordance with 84
sound actuarial principles and is designed to provide sufficient 85
revenues to pay current and future liabilities. 86
(f) That the plan is neither offered nor advertised to 87
the public generally. 88
(g) That the plan is required under the laws of its 89
domiciliary jurisdiction to maintain excess insurance with a 90
retention level determined in accordance with sound actuarial 91
principles. 92
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(h) That the plan is required under the laws of its 93
domiciliary jurisdiction to establish and maintain appropriate 94
loss reserves determined in accordance with sound actuarial 95
principles. 96
(i) That the plan is a nonprofit organization. 97
(i) Upon demonstrating to the satisfaction of the 98
commissioner that the Association Self-Funded Health Benefit Plan 99
is in compliance with the provisions of this act, the plan shall 100
be exempt from all other provisions of Title 83 of the Mississippi 101
Code and shall not be regulated by the Mississippi Insurance 102
Department. 103
(ii) An association self-funded health benefit 104
plan that receives an initial exemption under this section from 105
Title 83 of the Mississippi Code shall certify to the commissioner 106
each year thereafter, on or before February 15th, that the plan 107
continues to meet the eligibility requirements contained in this 108
act. Failure to meet and maintain the eligibility requirements 109
set forth in this act shall be grounds for denial, suspension or 110
revocation of the plan's exemption from Title 83 of the 111
Mississippi Code and its eligibility to provide group health 112
benefit coverage in this state. 113
SECTION 5. Any person who participates in an association 114
self-funded health benefit plan in Mississippi as described in 115
this act shall be provided written notice that the plan is not 116
regulated by the Mississippi Insurance Department and every 117
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purchaser or prospective purchaser shall be provided written 118
notice that the person's benefit plan is not otherwise regulated 119
under Mississippi law. 120
SECTION 6. Any purchaser or prospective purchaser of 121
coverage under an association self-funded health benefit plan as 122
described in this act shall be provided written notice that the 123
benefit plan is not covered by the Mississippi Life and Health 124
Insurance Guaranty Association. 125
SECTION 7. Any purchaser or prospective purchaser of 126
coverage under an association self-funded health benefit plan as 127
described in this act shall be provided written notice that 128
neither the costs of the plan, benefits, nor the benefit plan are 129
regulated by the Mississippi Insurance Department. 130
SECTION 8. Individuals in this state eligible for coverage 131
under an association self-funded health benefit plan shall be an 132
employee who is covered by an association plan in which an 133
employer is participating or a self-employed individual who is 134
covered by an association plan, including a dependent of an 135
employee or self-employed individual as defined under the terms of 136
the plan. 137
SECTION 9. This act shall not apply to a fully insured 138
association health benefit plan or to an association self-funded 139
health benefit plan that is exempt from state insurance regulation 140
in accordance with the provisions of the Employee Retirement 141
Income Security Act of 1974. 142
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SECTION 10. Nothing in this act shall preclude an 143
association from engaging an insurance producer licensed to sell 144
health insurance in this state for the purposes of reviewing and 145
considering any group health plan offered to an association under 146
this act. 147
SECTION 11. When reviewing an association self-funded health 148
benefit plan's request for a determination by the commissioner 149
whether the plan is exempt from Title 83 of the Mississippi Code 150
and is authorized under this act to provide group health benefit 151
coverage through a professional or trade association in this 152
state, the commissioner may retain attorneys, actuaries, certified 153
public accountants or other professionals and specialists to 154
assist in completing the review, the reasonable cost of which 155
shall be borne by the plan which requested the determination. 156
SECTION 12. Any third-party administrator administering an 157
association self-funded health benefit plan in this state shall be 158
licensed pursuant to the provisions of Section 83-18-1 et seq., 159
Mississippi Code of 1972. 160
SECTION 13. An association self-funded health benefit plan 161
providing coverage in this state pursuant to this act shall 162
designate the commissioner as its agent solely for the purpose of 163
receiving service of legal documents or process, for which a 164
filing fee shall be determined by the commissioner. 165
SECTION 14. An order issued by any District Court of the 166
United States enjoining an association self-funded health benefit 167
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ST: Association Self-Funded Health Benefit Plan
Act; enact.
plan from operating in any state (or in all states or in any 168
territory or possession of the United States) upon a finding that 169
such a group is in hazardous financial condition or financially 170
impaired condition shall be enforceable in the courts of this 171
state. 172
SECTION 15. The commissioner may adopt such rules and 173
regulations as shall be necessary to carry out the provisions of 174
this act. 175
SECTION 16. This act shall take effect and be in force from 176
and after October 1, 2026. 177