ACA Recap – Employer Checklist (Part 5 of 5): Exchanges
Types of Exchanges 1. State Exchanges – Individual Consumer – Federal or State Run Carrier participation will be voluntary State determines plan designs: Bronze (low cost), Silver, Gold, Platinum (high cost); Catastrophic Plan – young invincibles (18 -30) 2. SHOP Exchange – Small Employers Open in 2015 Limited to 50 FTE’s Employer picks plan for […]
ACA Recap – Employer Checklist (Part 4 of 5): Underwriting
Under ACA beginning with all new groups and for groups renewing in the 2014 calendar year the following criteria will be used to underwrite group. (In Florida, group size is determined by ATNE, Average Total Number of Employees. ATNE is calculated by averaging the total number all employees, full & part time, seasonal, temporary, etc… for […]
ACA Recap – Employer Checklist (Part 3 of 5): Compliant Plans
What is a Minimum Value Plan? Coverage that has an actuarial value (AV) of at least 60%. AV is the plan’s share of the total allowed cost of benefits provided to an enrolled individual Example, if a plan has an AV of 60% then the individual is theoretically responsible for 40% of the costs for all […]
ACA Recap – Employer Checklist (Part 2 of 5): Affordability
ACA Employer Responsibility Affordable Coverage Requirement Companies are only required to offer at least one medical plan that meets the “affordability” requirement (at the employee-only coverage level). Regulatory guidance allows companies to calculate affordability based on the employee’s income, using one of three IRS safe harbors. The Safe Harbors are: 9.5% of W-2 wages from […]
ACA Recap – Employer Checklist (Part 1 of 5): Accessibility
ACA Employer Responsibility: “Pay or Play” (Delay Announced) Large Employer Subject to “Pay” if they do not “Play” – Starting in 2015, applies to employers with 100 or more FTEs (Full Time Equivalents) Offer Minimum Essential Health Care to 70% of employees effective on the start of the plan year beginning on or after January […]