Employers who Offer Group Coverage...New Regulations

[Tkruger]

I'm familiar with the fact that if a group plan exceeds 9.5 percent of the employees adjusted gross income that it's deemed unaffordable and that qualifies the employee the ability to acquire coverage thru the exchange and potentially qualify for reduced out-of-pocket expenses based off their income.

This being said, I'm not as familiar with group and it's association to the ACA as what I'd like to be.

So here's the question: Is the employer who offers the group coverage Required to offer coverage that does not exceed 9.5 percent of the covered employees share of the benefit?

The initial research I've done isn't yielding data to back this up.

Input Ladies and Gents?

 

[Yagents]

No. You are confused. Search on "family glitch" and re-read the numerous threads on this topic. i'm going to guess that Ann is too tired to retype for the 37th time.

----------

http://www.insurance-forums.net/for...age-unaffordable-low-wage-workers-t54325.html

 

[kgmom219]

This being said, I'm not as familiar with group and it's association to the ACA as what I'd like to be.

My two cents...don't bother. Unless you are going after the 51+ market.

Most small groups are going to move into individual. And the ones that are keeping group are "rich" companies, where the employees are making $100K. And all of this 9.5% stuff (which I don't understand and don't particularly want to understand) doesn't apply to small business that are keeping group coverage.

 

[Tkruger]

No. You are confused. Search on "family glitch" and re-read the numerous threads on this topic. i'm going to guess that Ann is too tired to retype for the 37th time.

----------

http://www.insurance-forums.net/for...age-unaffordable-low-wage-workers-t54325.html

Y, deep breath...I have read as I mentioned before. Also, I wasn't speaking about a family, specifically an individual.

I just sat thru a presentation as a fly on the wall and that was the data they presented and is what generated the question.

 

[Yagents]

No biz is required under 50 employees.
No penalty either, no matter the % of affordability.
9.5% only matters for eligibility for tax credits

But, like KG mom said, not my market, and I don't do group

 

[Tkruger]

No biz is required under 50 employees.
No penalty either, no matter the % of affordability.
9.5% only matters for eligibility for tax credits

But, like KG mom said, not my market, and I don't do group

Actually Yagents, 2k15 it's 1-99 this doesn't apply...2k16 is 50 and up.

 

[yorkriver1]

Good information on this thread about which employers must offer coverage or receive a penalty. All employers large or small have the opportunity to help employees find out if they can waive employer coverage and receive a subsidy on Marketplace.

This document is a good summary of how Marketplace will interact with employers of any size, and about how the procedures work for informing employees of Marketplace.

http://marketplace.cms.gov/getoffic...d-and-faqs-on-employer-sponsored-coverage.pdf

I had one person during open enrollment who qualified to waive employer coverage and receive a subsidy on Marketplace. Employee's share was about $250, income about $20K. Employee cost obviously more than 9.5%.

Employees with employer coverage did not like their costs, but all others I encountered had incomes above the 9.5% rule. Yes, the saddest ones were the families with big employer insurance costs, still measuring employee single rate for "affordability".