December 2019 • Volume 107 • Number 12 • Page 8
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Health Care Insurance for Our Members
The ISBA and its pursuit of an Association Health Plan for members and their families and employees.
Let us imagine for a moment that each ISBA member had an opportunity to join the largest law firm in the world and enjoy the health insurance benefits that such a firm would give them and their families. Providing such a benefit to its members is the vision that the Illinois State Bar Association is exploring.
In the coming months, you will be receiving multiple communications from the ISBA regarding your interest and ability to enroll your firm in our anticipated Association Health Plan (AHP).
Simply stated, the AHP is the formation of a purchasing group to provide affordable and quality health insurance to ISBA members, their families, and employees. Created by federal regulation, AHPs permit associations like ours to negotiate with multiple insurers to formulate an insurance plan that will be available to members, provided a member has at least one W-2 employee in addition to the lawyer. Since most of our members have at least one employee, partner, associate, or staff worker, we are hopeful that we can provide a benefit of great value to our members.
The Association interviewed several well-respected consultants to guide us in the process. We have retained the services of Mercer, a consulting firm with extensive involvement and experience in the employee benefit and AHP planning and implementation process. Recently, you have received communications requesting a response to a very important survey that will assist us in exploring health insurance options for our members and their firms. Please respond to the survey (or have your firm’s office manager do so) and allow us to further investigate our prospects to form an ISBA AHP. The survey can be accessed at the Association Health Plan page.
More than 30 years ago, then-ISBA President Jerome Mirza announced the formation of the ISBA Risk Retention Group to provide quality affordable professional liability to our members. While that endeavor was met with skepticism by our potential insurance company competitors and a portion of our members, today the ISBA Mutual Insurance Company is among the highest-rated, bar-related providers of professional liability insurance in the country and the largest insurer of lawyers for such liability coverage in Illinois. TOGETHER WE CAN DO THIS.
What follows are answers to common questions concerning an ISBA AHP.
Would all my partners and employees have to enroll? No. Eligibility does not require 100 percent participation. The eligibility factor is whether there is at least one W2 employee—other than the owner—for a firm or practice to be eligible. Most carriers require a minimum of 50 percent participation from enrolling firms and practices.
Will the insurance be underwritten? Yes. The insurance will be underwritten by our carrier partner.
Will there be multiple plans or just one insurance plan? Typically, three to five medical plans are made available by associations to members, their families, and employees.
Who would need to pay the premiums for the insurance? The employer is typically required to pay a portion of the premiums. The portion amount varies by carrier, but often is in the 50 percent range of the employee-only premium.
How will the insurance be priced? An insurance plan is usually priced in banded rates that are determined after carrier underwriting takes place. That is, the carrier will underwrite and determine the appropriate band for each member company for pricing.
Will preexisting conditions be covered? Yes. All plans are ACA compliant.
Will the association have any financial exposure for the underwriting risks? Mercer recommends a fully insured Association Health Plan, as all such underwriting risks are retained by the insurance carrier.
How many firms or individuals would need to enroll to make the plan feasible? The amount of enrollees required will vary by insurance carrier and will be determined in discussions as part of the carrier solicitation process.
We look forward to your evaluation, input, and participation in what we hope will be an important expansion of member benefits. If you consider the value of your current membership benefits—Fastcase alone is worth $995; then, add CLE programs, the Illinois Bar Journal, Illinois Lawyer Now, E-Clips, vendor discounts, networking events and opportunities, and section involvement—an AHP plan has the potential to greatly expand what is already an incredible membership package that’s worth far, far more than the dues we pay.
Wishing you a safe and happy holiday season on behalf of the officers and staff of the Illinois State Bar Association.