Skinny Plans--A Solution for Play or Pay

If you are a member of the Health Underwriters, you may have noticed a recent article entitled Large Employers Like Skinny Plans.  Skinny plans, or Minimum Essential Coverage plans are indeed one legitimate solution to the play or pay dilemma facing large employers this Fall.  

Due to a loophole in the law, employers can offer a stripped down benefit for right around $55 monthly and avoid the $2000 penalty.  But there's definitely a catch.  Employees who refuse this product offering can still go to the exchange and if they access subsidized coverage, the employer will realize the $3000 fine.  Those who stay will satisfy the individual mandate however the benefits are well. . . skinny.  In most cases the benefits are limited to the preventive benefit under the ACA.  

The carrier we use to quote these plans is Century Healthcare.  Century has been in the limited medical benefits field for fifteen years.  Their biggest clients include Steak and Shake and Chik Fil A and they are underwritten by Companion Life on A+ paper.  We like CHC because they are easily the most flexible in the marketplace.  They will write the MEC only apart and they can write it mixed with limited medical plans.  Some other details include:

•             Fully customized Limited Benefit Medical plans that we can build from $50 to $500 on the EE only rate.

•             No medical underwriting, the limited benefit medical & MEC plans are guarantee issue.

•             Only 25 employees needed to enroll; we do not ask for a wage & tax report.

•             All of our plans pay first dollar benefits (NO deductibles & NO co-insurance).

•             The plans are COBRA eligible and we administer COBRA free of charge.

•             Century Healthcare pays a level 10% commission on both 1st year and renewal.

•             PHCS PPO network.

•             The product is written on “A+” paper from Companion Life Insurance Co.

•             Available to full-time employees, part-time employees and 1099 contractors. The employer defines eligibility.

The industries to target include:  nursing homes, home healthcare, restaurants, hotels, salons, staffing firms, janitorial firms, security guard firms, retail, manufacturing and any industry that employs large numbers of hourly workers.  

There are certainly more details to discuss when it comes to these plans but here are some resources to get you started:

Benefits Pro Magazine Overview on Skinny Plans

Wall Street Journal Article on the Plans

Overview of Century Healthcare

Please give me a call and we can either discuss our options or meet face-to-face.  

Dominic

616.481.8675

Pediatric Oral Benefit--Specifics of the Companion Renewals

Good news! The State of Michigan has approved Companion Life to be  ACA Certified Effective 1/1/2015.  Companion is working toward a process through which it will transition its groups to the pediatric oral benefit as requested.  In the meantime, here are some strategies that have worked so far to navigate the pediatric benefit while retaining Companion dental in groups:

1.  If it is a Blue group, you can write the pediatric oral benefit for the children with the Blues offering and keep the Companion with the adults.  It would be ideal to remove the children from the Blue coverage come 1/1 when Companion is certified but we realize this could be difficult depending on the current environment for group wide change scheduled allowances per year.

2.  Another idea is to use Delta Dental as a plan offering alongside a full Companion plan.  Delta offers stand alone pediatric and does not require a minimum enrollment so you and the group can offer employees the option of purchasing the pediatric benefit.  We've done this quite a lot for groups who might not have dental currently and it seems to go rather well.

3.  Finally, you can write the pediatric oral benefit with the Blues or Delta and write the brand new Companion Plus Wrap product.  It 'wraps' around the pediatric oral benefit.  The summary of this plan is below but in a nutshell, this still covers the children for benefits the pediatric benefit leaves out while covering the adults with a full dental plan.  This is a very cost efficient solution and allows adult members to continue their Companion coverage with no disruption to deductibles, etc.









































4.  Finally, it is an option to replace the Companion plan with Delta Dental, MetLife or the MMA who are all ACA certified this year 2014.