Bill Text: MS HB1236 | 2026 | Regular Session | Introduced
Bill Title: Associated Self-Funded Health Benefit Plan Coverage Act; create.
Sponsorship: Partisan Bill (Republican 2)
Status: (Failed) 2026-02-03 - Died In Committee [HB1236 Detail]
Download: Mississippi-2026-HB1236-Introduced.html
MISSISSIPPI LEGISLATURE
2026 Regular Session
To: State Affairs
By: Representative Burch
House Bill 1236
AN ACT TO CREATE THE ASSOCIATION SELF-FUNDED HEALTH BENEFIT PLAN COVERAGE ACT; TO DEFINE CERTAIN TERMS; TO AUTHORIZE AN ASSOCIATION IN MISSISSIPPI TO PURCHASE HOSPITAL, SURGICAL AND MEDICAL EXPENSE BENEFITS COVERAGE FROM A SELF-FUNDED ASSOCIATION PLAN SUBJECT TO THE JURISDICTION OF ANOTHER STATE INSURANCE DEPARTMENT OR THE FEDERAL GOVERNMENT; TO EXEMPT SUCH PLANS SUBJECT TO THE JURISDICTION OF ANOTHER STATE OR THE FEDERAL GOVERNMENT FROM THE INSURANCE LAWS OF THIS STATE AND REGULATIONS OF THE DEPARTMENT OF INSURANCE UPON DEMONSTRATING TO THE COMMISSIONER OF INSURANCE THAT CERTAIN REQUIREMENTS HAVE BEEN MET; TO REQUIRE WRITTEN NOTICE TO BE PROVIDED TO PLAN PARTICIPANTS AND PROSPECTIVE PURCHASERS THAT THE PLAN IS NOT REGULATED BY MISSISSIPPI LAW; TO AUTHORIZE THE COMMISSIONER TO RETAIN PROFESSIONALS TO ASSIST IN REVIEWING A PLAN'S REQUEST TO BE EXEMPT FROM STATE INSURANCE LAWS AND REGULATIONS; TO REQUIRE SUCH PLANS TO DESIGNATE THE COMMISSIONER AS ITS AGENT FOR SERVICE OF PROCESS IN MISSISSIPPI; TO AUTHORIZE THE COMMISSIONER TO ADOPT RULES AND REGULATIONS TO CARRY OUT THE PROVISIONS OF THE ACT; TO AMEND SECTION 83-5-3, MISSISSIPPI CODE OF 1972, IN CONFORMITY TO THE PROVISIONS OF THIS ACT; AND FOR RELATED PURPOSES.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI:
SECTION 1. Sections 1 through 15 of this act shall be known and may be cited as the "Association Self-Funded Health Benefit Plan Coverage Act."
SECTION 2. It is the purpose and intent of the Association Self-Funded Health Benefit Plan Coverage Act to provide additional group health benefit plan coverage options to associations located in the State of Mississippi by allowing their members to purchase coverage from self-funded association plans that are subject to the jurisdiction of another state insurance department or the federal government.
SECTION 3. As used in this act, the following words and phrases have the meanings provided in this section unless the context clearly indicates otherwise:
(a) "Association" means an association that works to unite, support, and represent fire service professionals across the State of Mississippi, and to strengthen the fire service, promote safety, and enhance the delivery of emergency services to the people of Mississippi.
(b) "Association self-funded health benefit plan" means a self-funded health benefit plan established in its domiciliary jurisdiction for the members of an association to provide group hospital, surgical or medical expense benefits to association members, including dependents.
(c) "Commissioner of Insurance" or "commissioner" means the Commissioner of Insurance of the State of Mississippi.
(d) "Fully insured association health benefit plan" means an association health benefit plan that provides group coverage for hospital, surgical or medical expense benefits, all of which are guaranteed under a contract or policy of insurance issued by an insurer authorized to do business in this state.
SECTION 4. (1) Except as otherwise expressly provided in this act, the provisions of Title 83, Mississippi Code of 1972, do not apply to an association self-funded health benefit plan that provides group coverage for hospital, surgical or medical expense benefits if the plan can demonstrate, to the satisfaction of the Commissioner of Insurance, that the plan is subject to the jurisdiction of another state insurance department or the federal government by providing the commissioner with the appropriate certificate, license or written authorization issued by the governmental agency that permits or otherwise qualifies the plan to provide group coverage for hospital, surgical or medical expense benefits.
(2) In addition to any other requirements set forth in this act, in order to be eligible to provide association group hospital, surgical or medical expense benefits coverage in this state and to qualify for the exemption from the provisions of Title 83, Mississippi Code of 1972, authorized under subsection (1) of this section, an association self-funded health benefit plan must demonstrate to the satisfaction of the Commissioner of Insurance the following:
(a) That the plan was established in its domiciliary jurisdiction for the members of an association that has been organized and maintained in good faith for a continuous period of no less than three (3) years for purposes other than obtaining or providing insurance;
(b) That the plan will provide group coverage in this state only through an association, which association has been organized and maintained in this state in good faith for a continuous period of no less than three (3) years for purposes other than obtaining or providing insurance;
(c) That the plan is in compliance with applicable laws in its domiciliary jurisdiction and any applicable requirements under the Employee Retirement Income Security Act of 1974 addressing coverage, financial and reserve requirements;
(d) That the rates are not inadequate, excessive or unfairly discriminatory and are appropriate for the classes of risks for which they have been computed;
(e) That the plan is being operated in accordance with sound actuarial principles and is designed to provide sufficient revenues to pay current and future liabilities;
(f) That the plan is neither offered nor advertised to the public generally;
(g) That the plan is required under the laws of its domiciliary jurisdiction to maintain excess insurance with a retention level determined in accordance with sound actuarial principles;
(h) That the plan is required under the laws of its domiciliary jurisdiction to establish and maintain appropriate loss reserves determined in accordance with sound actuarial principles; and
(i) That the plan is a nonprofit organization.
(3) Upon demonstrating to the satisfaction of the commissioner that the association self-funded health benefit plan is in compliance with this act, the plan must be recognized as being exempt from the provisions of Title 83, Mississippi Code of 1972, and is not subject to regulation by the Mississippi Department of Insurance.
(4) On or before February 15 of each year following the year in which an association self-funded health benefit plan receives an initial exemption under this section from the provisions of Title 83, Mississippi Code of 1972, the plan shall certify to the commissioner that the plan continues to meet the eligibility requirements prescribed in this act. Failure to meet and maintain the eligibility requirements set forth in this act is grounds for denial, suspension or revocation of the plan's exemption from the provisions of Title 83, Mississippi Code of 1972, and the plan's eligibility to provide group health benefit coverage in this state.
SECTION 5. A person who participates in an association self-funded health benefit plan in Mississippi authorized under this act must be provided written notice that the plan is not regulated by the Mississippi Department of Insurance, and every purchaser or prospective purchaser must be provided written notice that the person's benefit plan is not otherwise regulated under the laws of this state.
SECTION 6. A purchaser or prospective purchaser of coverage under an association self-funded health benefit plan authorized under this act must be provided written notice that the benefit plan is not covered by the Mississippi Life and Health Insurance Guaranty Association created under Section 83-23-211.
SECTION 7. A purchaser or prospective purchaser of coverage under an association self-funded health benefit plan authorized under this act must be provided written notice that neither the costs of the plan, benefits nor the benefit plan are regulated by the Mississippi Department of Insurance.
SECTION 8. A person in this state is eligible for coverage under an association self-funded health benefit plan if the individual is a member of an association, including a dependent of the individual as defined under the terms of the plan.
SECTION 9. This act does not apply to a fully insured association health benefit plan or to an association self-funded health benefit plan that is exempt from state insurance regulation in accordance with the provisions of the Employee Retirement Income Security Act of 1974.
SECTION 10. This act does not preclude an association from engaging an insurance producer licensed to sell health insurance in this state for the purposes of reviewing and considering a group health plan offered to an association under this act.
SECTION 11. When reviewing an association self-funded health benefit plan's request for a determination by the Commissioner of Insurance whether the plan is exempt from the provisions of Title 83, Mississippi Code of 1972, and is authorized to provide group health benefit coverage through an association in this state, the commissioner may retain attorneys, actuaries, certified public accountants or other professionals and specialists to assist in completing the review, the reasonable cost of which must be borne by the plan that requested the determination.
SECTION 12. A third-party administrator administering an association self-funded health benefit plan in this state must be licensed under Chapter 18, Title 83, Mississippi Code of 1972.
SECTION 13. An association self-funded health benefit plan providing coverage in this state pursuant to this act must designate the commissioner as its agent solely for the purpose of receiving service of legal documents or process, for which a filing fee will be determined by the commissioner.
SECTION 14. An order issued by a United States District Court enjoining an association self-funded health benefit plan from operating in one or more states or in a territory or possession of the United States upon finding that the group is in hazardous financial condition or financially impaired condition is enforceable in the courts of this state.
SECTION 15. The commissioner may adopt such rules and regulations as may be necessary to carry out the provisions of this act.
SECTION 16. Section 83-5-3, Mississippi Code of 1972, is amended as follows:
83-5-3. (1) Except as otherwise provided in subsection (2) of this section, every insurance company, foreign or domestic, that qualifies to do business in the State of Mississippi shall be required to execute an agreement to be bound by the statute laws of the State of Mississippi pertaining to the periods of limitation prescribed by the statute law of this state.
The insurance commissioner is hereby required, as a condition precedent to authorizing any insurance company to qualify and operate under the laws of this state or to do business in this state, to require said companies to execute an agreement binding said company to conform to and to be bound and regulated by the statute laws of this jurisdiction as defined in the first paragraph.
For purposes of the administration of this section, insurance companies shall consist of all types of insurance companies, both domestic and foreign, that operate in this jurisdiction, including stock companies, mutuals, and fraternal societies and organizations when such fraternal society or organization engages in the insuring of its members or other persons.
(2) This section does not apply to an association self-funded health benefit plan exempt from the provisions of Title 83, Mississippi Code of 1972, under Sections 1 through 15 of this act.
SECTION 17. This act shall take effect and be in force from and after July 1, 2026.
