OSMA's Health Benefits Plan
Frequently Asked Questions
A MEWA is a multiple employer welfare arrangement. A MEWA provides health and welfare benefits to employers of two or more employees who pool their contributions, enabling them to offer health insurance rates and benefits typically available only to larger groups.
MEWA’s offer a variety of plan designs that meet the minimum essential coverage requirement of the ACA. They offer many deductible options with copays and prescription drug cards and High Deductible Health Plans compatible with Health Reimbursement Accounts (HRA) and Health Saving Accounts (HSA). In many cases these plans may be less expensive than comparable options available through the ACA Marketplace, and are not subject to some of the federal taxes and state health mandates of the ACA. MEWA’s also allow for changes in benefits and contribution rates at renewal without being “locked in” by the grandfathered status.
The Ohio Department of Insurance and several federal government agencies coordinate the oversight and regulation of MEWA’s. This multi-jurisdiction gives the State of Ohio’s Department of Insurance primary responsibility for overseeing the financial soundness of MEWA’s, while the U.S. Department of Labor provides oversight for employee benefit plans and the Internal Revenue Service ensures the nonprofit tax status of the MEWA Sponsor.
In the unlikely event a MEWA does not have sufficient funds to pay beneficiary claims; most reinsurers have contractually agreed to cover any unfunded beneficiary claims. This provision along with other reinsurance programs greatly reduces or eliminates a key risk of this arrangement.
Due to the constant policy evolution of the ACA and the uncertainty of future year premiums, many groups will be able to experience a competitive rate that may not be available from Ohio’s ACA Marketplace. The OSMA Insurance Agency will provide an easy-to-understand comparison between the ACA plans and MEWA plans.
No. The coverage will be offered with no pre-existing condition exclusion.
There is no fee to join a MEWA but the business will need to be an active member of the sponsoring Association or Chamber of Commerce.
In lieu of monthly insurance premiums each group will have a monthly funding rate based on a variety of factors including but not limited to:
Number of Covered Employees
Medical History
Gender
Age
Tobacco Usage
Location
Your rates will also include expected claims, fixed components such as administrative fees and stop-loss premium (a form of protection against excessive claims for your group and the overall MEWA Trust), taxes and assessments and will be billed on a monthly basis.
All the MEWA’s that our Agency deals with have large provider networks and facilities that likely would include your doctor and hospital. You should; however, always check to make sure your doctor is in network prior to any service.
Members may elect to withdraw from participation in the Plan at the end of a calendar month by giving written notice to the Plan at least thirty (30) days prior to the end of such month.

Service Satisfaction
“We have been a client of the OSMA Insurance Agency since 2009. They managed our previous Anthem plans and our OSMA HBP MEWA (Medical Mutual) plan as well. We are very happy with the OSMA health plan, in addition to all of the other services that they provide. Can't forget to mention how much we love our agent! She is extremely knowledgeable, kind, courteous and professional. I never have to worry because I know she's always on top of everything!"
Lacie Stollings • Kidney Care Specialists, LLC
