One of the expressed goals of the Affordable Care Act, when it was passed by Congress in 2010, was to make affordable health insurance available to more people. Unfortunately, that didn’t materialize for everyone – even for those covered by their employers’ health benefits.
For instance, the Kaiser Family Foundation and Los Angeles Times’ 2019 survey found that two in five adults covered by employer-sponsored insurance reported difficulty affording medical care, prescription drugs or premiums.
In an attempt to lower premiums, many employers have turned to level-funded plans that offer health benefits. Level-funded plans can save employers money by paying the claims of their employees with their own money instead of insurance premiums. Plus, 12 level monthly payments each year cover all the costs for an employer’s group plan.
One of the most affordable level-funded options are Minimum Essential Coverage Plans (MEC).
More and more individuals have increasingly turned to self-employment, freelance jobs and contract employment opportunities in the wake of the COVID-19 pandemic. This has contributed to a gig economy that experts say is now growing at a faster pace than the traditional employment market.
Open enrollment is just around the corner. There are many ways you can help your company operate more strategically and efficiently by opting for level-funded health plans. Not only does a level-funded health plan benefit employees, but you might find that there are plenty of ways these plans help you out as well.
Graduates will be searching for options
According to a study by Georgi Todorov – “19 Shocking College Graduation Statistics and Facts ” – nearly 3 million students this year will graduate from an accredited college or university, but only 65% of them will have full-time employment within a few months of graduation. A recent banking crisis and other economic turns have analysts warning of a coming recession, which could make work increasingly hard to find for young adults. This could lead to a considerable insurance coverage gap in the marketplace.
Pop quiz: You develop a rash. Who should you see for care?
It depends on how serious your rash is and when it occurs. Experts say if it’s not serious and you can wait, then you should make an appointment with your doctor. However, if the rash bothers you enough you can’t wait, a walk-in clinic is a reasonable option. A less expensive, usually quicker option would be to call your telehealth provider. If your rash is causing you extreme discomfort, urgent care would be a good choice. But if you have both a rash and a fever or trouble swallowing, you should go to the emergency room at a hospital.
Health care costs have been trending upward for a number of years. Employers in the U.S. expect the cost for medical plans per employee to raise 5.6% on average in 2023, according to Mercer, a human resources consulting firm. This has led many employers to search for affordable insurance options to lower expenses without sacrificing quality for their employees.
With traditional group health insurance plans, employers use their bargaining power to purchase coverage from insurance companies at a lower rate than individuals usually pay, and they cover a majority of employees’ premiums. The insurance companies pay employees’ claims using the premiums paid by the employer and keeping all unused premiums for themselves.
Level-funded group health plans allow employers to pay for claims themselves, saving money on profits that typically go to insurance companies and are protected by stop-loss insurance that caps their total claims exposure. These plans have become increasingly popular among small employers because they set level monthly payments, the same as a tradition insurance plan. These payments go towards covering the estimated costs of expected claims, administrative costs and stop-loss insurance. But with a level-funded plan, employers can actually see money returned when their group has a healthy, low-cost year.
Telehealth, also called telemedicine, allows you to receive health care without an in-person visit to a provider by using computer, tablet or smartphone.
Telehealth technically started in the 1940s in Pennsylvania when providers realized they could send radiology images over the phone lines between two townships. In the 1950s, a Canadian doctor expanded on the concept and constructed a teleradiology system that was used in and around Montreal. And in 1967, the University of Miami School of Medicine partnered with a local fire department to transmit electrocardiographic rhythms over radio to Jackson Memorial Hospital in rescue situations.
With the school year beginning, that means kids across the country are back to playing sports in middle school, high school and college. In addition to playing for their schools, some student athletes participate in club athletics over the course of the year.
As the parent of a student-athlete, you obviously know what’s best for them when it comes to their athletic careers and that includes being prepared for things like injuries in case the schools and athletic organizations don’t have medical coverage.
It’s no wonder small businesses are confused when they are told they need to file Form 5500 with the Internal Revenue Service (IRS) and pay PCORI fees. For instance, if you look up 5500 filing requirements on the Internet, most sites say something like, “Form 5500 is required on behalf of any welfare benefit plan that has 100 or more participants as of the beginning of the plan year or is funded through a trust, regardless of participant count.”
Clear as mud to the average employer, right? WRONG! Let’s break it down.
A minimum essential coverage (MEC) plan that doesn’t provide minimum value can still be an asset to large employers providing health coverage.
First, it helps to understand the definitions of minimum value and minimum essential coverage.
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Allied National is a 90 Degree Benefits Company, a subsidiary of Blue Cross Blue Shield of Alabama. Founded in 1970, Allied National is one of the nation's oldest and most experienced third-party administrators. We're the small group benefit experts working to provide unique and affordable group health benefits to small business employers.