All of The Health Benefit Alliance solutions are ERISA compliant, available in all 50 states, and follow all applicable state guidelines and regulations. They range from the most robust set of Minimum Essential Coverage (MEC) and Minimum Value Plan (MVP) options available, on up to the most comprehensive Qualified Metallic equivalent solutions available in the market.
These solutions are not designed to exempt plan sponsors or beneficiaries from applicable State and Federal regulations, but are designed to efficiently and completely satisfy such regulation.
Affordable Care Act Compliant Plan Designs
The Health Benefit Alliance MEC, Enhanced MEC, Minimum Value Plans (MVP) and Qualified Metallic Equivalent benefit options do more than meet Affordable Care Act (ACA) requirements. They are all managed on a single administrative platform under a single risk umbrella, therefore eliminating waste and providing the means to manage risk in the most cost-effective manner.
The breakout of an employer population by classes of employees or for geographic consideration greatly reduces the efficiencies that can be achieved with the single-platform, single pool of risk model. This helps employers to reduce healthcare costs while providing multiple benefit options that encourage employee participation, increase employee satisfaction and reduce employee turnover.
PROTECTION FROM ALL PENALTIES UNDER THE AFFORDABLE CARE ACT
There are 3 primary obligations and areas of exposure that employers have under the ACA that if not satisfied can result in significant after-tax penalties. These penalties apply to employers who fail to offer any coverage, or who offer coverage that does not provide Minimum Essential Coverage (MEC) to at least 95 percent of their full-time workers. Penalties also apply to employers whose coverage offerings fail to meet a standard for quality and/or affordability. There are also non-filing penalties.
The Sledgehammer or “A” Penalty
This penalty is imposed on employers who fail to offer any coverage. Employers subject to this penalty will pay $2,570 per year for each full-time employee after excluding the first 30 full-time employees from the calculation. So, employers who are subject to this penalty will be charged $214.17 per month per full-time employee. Keep in mind that the ACA considers “full-time” any employee who works at least 30 hours per week or more on average during the designated period.
The Tack Hammer or “B” Penalty
A lesser penalty applies to employers who offer a health plan that does not meet ACA standards – either for quality or affordability: the so called “tack hammer” penalty. An employer subject to this penalty will pay $3,860 for each Full-Time employee (if they obtained a subsidy on an exchange) after excluding the first 30 Full-Time employees from the calculation. So, employers who are subject to this penalty will be charged $312.67 per month per eligible employee who is subject to the penalty. The exception to this penalty is that the total amount must not exceed the amount the employer would have paid as a penalty for offering no coverage at all. So, there is a financial break, as far as penalties are concerned, for offering even minimal coverage. This penalty also makes an exception for any full-time employee who is in a Waiting Period.
The Non-Filing Penalty
The third type of penalty applies to employers who fail to comply or fail to properly document their compliance. This is the Non-Filing Penalty. Employers who fail to file year-end 1095-C and 1094-C forms with the IRS will be penalized a minimum of $540 per eligible employee. This penalty is similar to the one for failing to file W-2 forms for employees.