The Benefits Battle U are fightin' is already WON

Tired of trying to find and fund a Benefits Plan that meets the ACA Rules for Large Employers (over 50 employees). Tired of trying to find a plan all employees can afford?

Let's Solve the Problem: Fix the Large Group ACA Part A/Part B Problem with new solution.

Problem #1: ALE-Employers want to offer good insurance that fits their ownership and management tiers. Most remaining employees can’t afford it. The management tier coverage does not fit the Cost Guidelines for ACA Part B. What is a Large Employer as determined by the IRS?

Result

-Enrollment is down

-Participation Surcharges are included in rate. 

-DTQs from carriers 

-At risk for Part B Fine of $4,350 per ee

Solution

Include Elite SmartCare Plan as part of benefits offering. Employer contributes 60% of premium to create ee costs that match or exceed maximum cost guidelines. 

What is the Elite SmartCare Plan?

A comprehensive minimum essential coverage plan.  Elite was accredited by an actuarial/accounting firm to meet Part A and Part B ACA ALE guidelines. This plan includes doctor visits, specialist visits, imaging, rx, urgent care, ER, AND inpatient coverage. Built to replace a no plan scenario (not a Major Medical).  This plan becomes available September 1.

Problem #2 

ALE: Large Employers do not want to or can’t offer a viable health plan that fits their blue collar/grey collar/manufacturing/trades employee population. 

ACA Fines risk which is Part A $2,900 per ee

and Part B $4,350.

Results: 

-No carriers will offer coverage that fits the budget and does NOT have underwriting/participation guidelines.  The employer is frozen. 

-Employer has a subpar benefit offering with over average ee costs. 

UNTIL NOW

Solution:

Implement the Elite SmartCare Plan. $369 per month ee premium. No underwriting. Actuarially meets both Part A and Part B requirements.  Minimal cost for Employer to put strong coverage in place.

4 Step Setup Process:

1. Submit Census that includes First/Last name, dependents, zip code, and genders. 
2. Use this to Determine employee pricing by age. 
3. Fill out enrollment doc on HR Software or excel and submit to SmartCare 7-10 business days prior to start of plan. 
4. Create and sign SmartCare Level Funded plan using DocuSign documents. Then Setup payroll at the employer level. ID cards come back in 5-7 days. 

Want to discuss your situation? Are you an HR or Benefits Expert? Business Owner.

Schedule time here with Chad to get more details