A multiple employer welfare arrangement (MEWA) is an arrangement that covers employers with 2 to 50 employees. The Ohio Chamber of Commerce (Ohio Chamber) is the sponsor the Ohio Chamber Health Benefit Program (“OCHBP”), which is a self-funded non-plan MEWA that allows smaller companies to access health benefits with rates and premiums that are usually available to larger companies. Health benefits under the OCHBP are provided to eligible employers by the OCHBP Trust (“OCHBP Trust”). UnitedHealthcare provides claims administration and stop loss protection to the OCHBP Trust.

Any Ohio Chamber member company located in Ohio in good standing with 2 to 50 eligible employees may apply.

Participating employers are required to maintain membership with the Ohio Chamber, which is the sponsor of the OCHBP. Benefits are provided by the OCHBP Trust, which is governed by a Board of Trustees elected by participating employers. State law requires the OCHBP Trust to have a minimum of 300 enrolled employees within a period of time following start-up of its operations. Efforts are under way to begin operations July 2019.

The OCHBP Trust harnesses economies of scale that allow small businesses to band together to obtain health benefits at rates comparable to larger self-funded single employers. Each participating employer is the sponsor of its own group health plan under ERISA and must assume certain responsibilities under state and federal benefits law; including reporting, disclosure, and fiduciary provisions. Participating employers, however, are able to leverage the expertise of the benefits administrator, UnitedHealthcare, in meeting these benefit plan obligations.

The OCHBP Trust offers a new way to provide your employees with health benefits and has some great financial benefits for you. It’s a self-funded MEWA designed for Ohio Chamber member companies with small business needs in mind. It was sponsored by the Ohio Chamber to help its small business members and their employees with the increasing cost of healthcare benefits.

Yes. While the Ohio Chamber Trust is not an employee benefit plan under law, it is subject to state and federal laws designed to ensure that health benefits meet legal standards. In addition, each employer that joins the OCHBP Trust must adopt its own self-funded group health plan, which will be subject to ERISA’s reporting, disclosure and fiduciary provisions. The benefits provided under the Trust are similar to benefits offered by UnitedHealthcare to fully-insured large employer groups in Ohio.

Yes. Each employer participating in the OCHBP Trust will be provided with a Benefits Booklet that will summarize the benefits to which their covered employees and dependents are entitled. Participating employers will also receive a Participation Agreement, along with a Trust and other informational documents that will set forth the rights and responsibilities of employers with respect to the OCHBP and OCHBP Trust.

Yes. OCHBP is licensed as a self-funded MEWA under Ohio law. The OCHBP Trust operates pursuant to a Certificate of Authority issued by the Ohio Department of Insurance.

Yes, although some of the requirements applicable to insurance offered to small employers under the ACA do not apply to the self-funded benefit plans offered by the OCHBP Trust. The group health plans sponsored by employers participating in the Trust include all of the health benefits and protections required of large employers and MEWAS under state and federal law.

Yes. The ACA consumer protections that apply to large group coverage will apply to participating employers. This includes the prohibition on pre-existing condition exclusions, “no” lifetime/annual limits, and coverage for children up to age 26.

The OCHBP uses UnitedHealthcare’s health care provider network – one of the largest provider networks in the state. You should, however, always check to make sure doctors are in the network prior to any service using the “locate a provider” tool on myuhc.com®.

Yes. Rates for coverage can be adjusted under Ohio law based on the employer group’s health factors to the extent permitted by rating rules applicable to small groups under Ohio law.

Participating Employers may elect to withdraw from participation in the OCHBP Trust at the end of a calendar month by giving written notice to the Trustees at least thirty (30) days prior to the end of that month, except in limited situations. Because this is a self-funded MEWA, an employer group leaving the OCHBP Trust may be required to pay, on a pro rata basis, the liabilities of the OCHBP Trust to the extent the OCHBP Trust is operating at a deficit at the time the employer leaves. These withdrawal liability rules are set forth in the Participation Agreement and ensure the financial health of the Trust.

Yes. We provide each Participating Employer with a Benefits Booklet for the Trust that summarizes the Trust’s rules and the benefits to which a covered employee is entitled. The Participating Employer will be responsible for distributing the Benefits Booklet (along with ERISA information) to all of their covered employees to meet the ERISA requirement to have a Summary Plan Description or SPD.

The Ohio Department of Insurance has issued a Certificate of Authority to the OCHBP which demonstrates that the Trust is being operated in accordance with applicable laws. Each Participating Employer, in turn, is the sponsor of an ERISA covered self-funded group health plan subject to the jurisdiction of the U.S. Department of Labor’s Employee Benefits Security Administration (EBSA), which maintains a Regional Office in located in Ft. Wright, Ky. This multi-jurisdictional oversight should provide assurance to Participating Employers and their covered employees that health benefits provided by the OCHBP Trust are in accordance with applicable law.

For more information or to get a quote, please contact your broker or call (614)629-0913. You can also email questions to scolby@ohiochamber.com.