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Essential Staff Care FAQ’s

31 Dec


Important ACA Compliance Announcement

You are receiving this notice because you are considered a large Employer under the Affordable Care Act (“ACA”) for 2015. We have run reports through our ACA compliance tracking software (TRAX) to determine the number of full-time equivalent (“FTE”) employees you had in 2014. A copy of your report is available upon request.
In the coming days you will receive an introduction call from Planned Administrators, Inc. (“PAI”), who will work with you to implement one of the two ACA compliant health insurance plans for your company. PAI offers both a minimum essential coverage (“MEC”) and minimum value (“MV”) plan. The following note on Essential Staff Care insurance provides important information about these plans.

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How the MV and MEC Plans Work

  • These plans are considered self-insured policies however, they are “max funded”. This means that you do not have any financial liability beyond the “fully insured premium equivalent rates” that you will pay. Within a self-funded plan, there can be a surplus or deficit at year end, any deficit will be paid automatically by the stop loss carrier, so you would never be responsible for any amount beyond the premium payment. However, any surplus will be refunded, and can be used for any other “benefits related” expense, or left in the account for future expenses with PAI.
  • The MV plan for the 2015 policy year does not include hospitalization. The IRS is allowing the MV plan to not include hospitalization for one year only. Groups will be given until March 1, 2015 to implement, so this will be your effective date for both the MEC and MV plans.
  • Employer Contribution Requirements for the MV Plan
  • Employees must pay their health insurance premiums directly

Timing and Deadlines

  • In order to achieve a March 1, 2015 effective date, we must start open enrollment NO LATER THAN January 15, 2015.
  • Open enrollment runs from 1/15/2015 to 1/31/2015.
  • PAI will mail enrollment information to employees with “direct payment” instructions by February 15, 2015.

PLEASE REMEMBER to respond to the email that PAI sends after the introduction call. You’ll need to send them your company logo for the enrollment packets.

  • Your company has been deemed a Large Employer, but the number of employees PAI will reference are the active Employees in Vensure’s payroll system and not necessarily your 2014 FTE count.
  • Enrollment applications can be electronic or hard copy. PAI will provide both.
  • Employees will get a packet of information sent to their home address. This will notify the Employee to go to the appropriate benefit website to elect how they would like to pay for their coverage.
  • Coverage for the Employees begins the Monday after the first deduction in March.
  • Once the Employee makes their first payment, PAI will invoice you between the 15th and the 20th of the month, but only for the Employer portion of MV premium for those Employees who enrolled in the MV.
  • If an Employee does not pay their portion of the premium, they will have a 30 day grace period to bring their balance current before the insurance policy terminates.
  • If the Employee doesn’t pay during this time, the coverage will be canceled and you will receive a refund of premium you paid for that Employee.
  • Employees will not enroll in both the MEC and MV health plans. The MEC should be taken by all Employees who do not enroll in the MV plan. We will notify you of those Employees who you must offer MV coverage to.
  • PAI will conduct an Implementation call with you following the introduction call.
  • Each policy has its own application. Please make sure your Employees use the right application for the policy they want.

Should you have any questions regarding Essential Staff Care insurance, please do not hesitate to contact benefits@vensure.com.

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