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PPACA Compliant Health Plans

Are you concerned about paying tax penalties under PPACA for not offering benefits to your employees?

Are you confused about the new rules under PPACA and how they apply to your company?

Have you been told that you will have to spend large amounts of additional money due to PPACA?

Are you considering just dropping your benefits and paying the PPACA tax penalties?

Have you looked at typical Bronze plans and found them unaffordable?

HCP solves these problems.

If ObamaCare has you worried, we can help. It may be tempting to throw up your hands and pay the fines rather than attempting to navigate the confusing landscape of the ACA. But this course of action is unnecessary, and could mean the loss of thousands of dollars for your business that you simply did not have to lose. We offer insurance solutions that will make you Obama Care compliant for far less than the cost of typical health insurance plans or ACA fines.

Don’t assume you can’t afford to become ACA complaint.

In truth, you can’t afford not to become ACA compliant. The $3000 or $2,000 fines are not tax-deductible, and cutting employee hours leads to hidden costs that you may not be considering. Our company worked with major professionals throughout the insurance industries to create solutions that are actually affordable for businesses with 100 or more fulltime and costs significantly less than the penalties associated with attempting to avoid ObamaCare.

If you have 50 or more employees or will have 100 or more employees by 2016, read on.

What is the definition of Minimum Essential Coverage (MEC) which, when offered by an employer to all full-time employees and their children (spouse coverage is not required), or which is purchased by an employee individually through an employer sponsored or Self-Funded Benefit Plan, will enable both the employer and employee to avoid some of the penalties (taxes) under PPACA?
MEC need only cover 100% of the CMS listed Preventative and Wellness benefits.
  • An employer that employs 50 or more full-time employees (full-time plus part-time equivalents) can prevent being taxed the $2,000 per full-time employee, less 30 employees, penalty by offering the MEC.
  • An employee can prevent being taxed the “Individual Mandate” coverage penalty for not purchasing MEC by purchasing this minimal coverage through his/her employer. Beginning in 2014, employees will face a tax of the greater 1% of adjusted household income or $95 per adult plus $47.50 per child; in 2015, the greater 2% of adjusted household income or $325 per adult plus $162.50 per child; thereafter, the greater 2.5% of adjusted household income or $695 per adult and $347.50 per child

How much can the employer charge the employee for the Minimum Essential Coverage (MEC)?

Employers can charge employees any reasonable amount for the MEC.

Does an employer have to offer any other type of coverage, such as Minimum Value Plan (MVP) in order to avoid the $3,000 penalty if an employee who is eligible for subsidies on the Exchange waives off of an employer group plan and purchases coverage on the Exchange?

Yes. Employers need to offer an MVP which meets the government’s 60% rule of “allowed costs” in order to avoid the $3,000 penalty tax per employee who is eligible for subsidies on the Exchange, who waives off the employer plan, and who purchases coverage on the Exchange.

The employer cannot charge any full-time employee more than 9.5% of that employee’s W2 Box 1 income for the MVP. The W2 Box 1 income equals the employee’s total income minus his/her contribution to the pension plan minus any monies he/she set aside in a Flex 125 program. This 9.5% limitation applies only to the single contribution rate of the MVP but not for the charge attributable to any dependents (Safe Harbor).

Or…the employer cannot charge any full-time employee more than 9.5% of that employee’s total adjusted household income using W2 wages.

That’s why we offer a buy up, low-cost bronze 60% AV plan that does not require 70% participation.

Plan A: Self-Funded Minimum Value Plan/Bronze MEC + Outpatient + RX (MOR)

  • This is the lowest cost Bronze MVP available.
  • 60% Minimum Value Plan with Minimal Essential Coverage (all 63 CMS listed preventative services) with an aggregate to provide immediate funding. The 60% MVP meets the government’s requirement for minimum essential coverage (MEC).
  • This allows the employer to avoid the $3,000 penalty for any employee who waives the employer plan and purchases coverage on the exchange.
  • Outpatient services will be covered with low co-pay. A fully insured hospital buy-up available benefit can also be purchased.
  • Outpatient prescription services will be covered with low co-pay.
  • No Claims Experience or Census Required, rates will be based on zip code.
  • 70% participation not required.
  • Employer can offset costs by having the employee pay up to 9.5% of the employees W-2 income. In many cases, the employee may pay the entire cost.
  • 100 full-time employees or more.

Plan B: Self-Funded Minimum Essential Coverage Preventative Services (MEC).

  • This is the lowest net cost MEC plan available. The typical cost for Minimum Essential Coverage would only be $36 per person, per month!

  • Minimum Essential Coverage could be self-funded with an Aggregate only policy with a monthly Aggregate Accommodation provision.

  • Minimum Essential Coverage will cover 100% of the 63 CMS listed preventative services.

  • An employer that employs 50 or more full-time employees (FT plus full-time equivalents) can prevent being taxed $2,000 per full-time employee, less than 30 employees, by only offering the Minimum Essential Coverage.

  • All employees can prevent being taxed the greater of the $95 penalty or 1% adjusted household income by purchasing the MEC only plan.

  • The employee penalty progresses over a three-year period. In 2014, it is the greater 1% of adjusted household income or $95 per adult plus $47.50 per child; in 2015, it is the greater 2% of adjusted household income or $325 per adult plus $162.50 per child; thereafter, the greater 2.5% of adjusted household income or $695 per adult and $347.50 per child.

  • Employers can charge employees any reasonable amount for the Minimum Essential Coverage.

Plan C: Self-Funded Bronze Plan with High Deductible (MEC)

  • 60% Minimum Value Plan with Minimum Essential Coverage (all 63 CMS listed preventive-services) high deductible plan with Specific and Aggregate stop loss protection.

  • May have a maximum deductible of $6,350 per single and $12,700 per family and 100% coverage after that.

  • No Claims Experience Required.

  • Can provide a fully insured optional medical benefit plan to supplement the high-deductible bronze plan (Not Available in CA).

  • 70% participation not required.

  • Employer can offset costs by 9.5% of the employee’s W2.

  • 100 full-time employees or more.

  • The 60% MVP meets the government’s requirement for minimal essential coverage (MEC). This allows the employer to avoid the $3,000 penalty for any employee who waives the employer plan and purchases coverage on the Exchange.

FAQ’s

Is this a self-insured plan?
Yes and we provide aggregate stop loss that will set the maximum cost per employee.

Is it cheaper to pay the fines?
No our solution can be paid by the employees thereby making the cost a lot less than the fines.

Do I need claims experience to get a quote?
No

Can I work with my broker instead of HCP?
Yes have them contact us.

Are there participation requirements?
No

Are certain industries excluded?
No

How reasonable is the cost?
If you have your employees contribute 9.5% of their W2 (safer harbor) income the net cost could be nothing

What is a MEC?
Minimum Essential Benefit Coverage which provides the 63 CMS preventable services. If MEC is provided, the employer can avoid the $2,000 fine.

We’re your trusted partners, helping you become ACA compliant without breaking the bank!

We understand your needs as a business owner. We know that you have to create the best possible outcome for your business: keeping profits high and expenses low. Let one of our Sales Representatives show you how one of our ObamaCare compliance products will offer you the best possible situation, allowing you to keep more money in your pocket, secure employee loyalty, and stay on the right side of the law.

You don’t have to cripple your business! From New York to California, your ACA solution is just a phone call away. Just call 1-888-478-6756 to speak with an HCP National representative about your specific situation today.

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Since 1994 – HCP’s top priority is finding clients the best possible coverage and terms at the lowest possible cost. HCP is a certified diverse (MBE & WBENC) insurance brokerage.
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