How are the rating rules for an Association Health Plan different from the normal adjusted community rating rules?

The rating rules for an AHP are based on the total number of members in the association. Most will have more than 50, so they will play by the large group rating rules.

This means that modified adjusted community rating does not apply.

Large group plans can rate based on industry, group size, gender, age (with more than 3 to 1 rating), participation, etc.

Geo-AHPs cannot underwrite. They must accept groups that meet the participation and contribution requirements.

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