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MedBen University Details Reform's "Pay or Play" Concept

06/25/13

  12:16:48 pm, by MedBen5   , 298 words,  
Categories: News, Health Plan Management

MedBen University Details Reform's "Pay or Play" Concept

MedBen Vice President of Caroline Fraker

School may be out for the summer, but MedBen University remains in session! Our team of experts is traveling the Midwest to share its knowledge of health care benefits with employers of all sizes.

At an MBU on June 25 in Lima, Ohio, MedBen Vice President of Caroline Fraker spoke on the topic, “Health Care Reform; Are You Ready for the Next Step?” In her presentation, Fraker discussed how the Affordable Care Act will impact businesses starting in 2014, focusing on the shared responsibilities for employers and individuals. The event was hosted by Stolly Insurance Group.

A key for employer groups to recognize their responsibities under health care reform, Fraker explained, is understanding the “pay or play” rules found in the law. For a group to “play” – that is, to be legally required to offer employee health care coverage – it must have at least 50 full-time equivalent employees. “Full time” is defined as an average of 30 or more hours per week or 130 hours a month.

A group that has to “play” must provide minimum essential coverage to its full-time employees and their dependents as defined under the ACA. Failure to do so means that the employer must “pay” a penalty – either a greater penalty if it does not offer essential coverage, or a lesser penalty if, under the rules, the coverage offered does not have minimum value or is not affordable.

With less than 100 days to go before open enrollment begins for health insurance exchanges, it’s critical for companies to understand how the “pay or play” concept will affect their health care coverage. In that spirit, MBU will continue to continue to offer seminars throughout 2013, to help employers better navigate their responsibilities under the ACA. Be sure to check this blog for future opportunities to attend a session!

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