Build Group Health Coverage Starting With Lowest Price, Building Up
OptiRater Provides Quick and Easy Quoting To Pinpoint Most Effective Plan
Looking for the lowest cost health coverage for a group of 50 or more full-time equivalent employees?
Can your employer afford somewhere around $50 per month per employee, with the likelihood that a portion of these premium-equivalent payments will be refunded?
OptiMed’s Minimum Essential Coverage, a level-funded health plan, provides the preventive services mandated by the Affordable Care Act (ACA) to satisfy the $2,700-per-employee penalty for Applicable Large Employers (ALE). On a 100-person group, the savings amount to about $150,000 typically.
Details are presented in a 40-minute webinar conducted recently by George Lose, Vice President of Sales at OptiMed, which follows this post. According to Lose, many brokers are not aware that a level-funded MEC satisfies the strong penalty of the ACA. He identifies groups dominated by hourly employees with relatively modest wages as the ideal candidates for MEC and provides a formula for determining feasibility.
Depending on employee income level, MEC may leave the employer susceptible to a $4,060-per-employee penalty for employees who purchase individual coverage on the ACA Exchange. This is explained thoroughly in the webinar.
MEC is a starting point. It covers preventive services only but OptiMed offers five buy-up options in enhanced MEC plans that add one or more of the following:
- Primary Care Doctor Visits
- Specialist Doctor Visits
- Urgent Care Visits
- Mental/Behavioral Health
- Maternity Pre/Post Natal
- Mental/Behavioral Health
- X-Rays, Labs, and Imaging
- Emergency Room
Providing more coverage, naturally, escalates the monthly premium equivalent. The buy-up plans also require minimum enrollment of either 10 or 25.
Alleviate Out-of-Pocket Expenses
One of OptiMed’s dozen or so Limited Medical Indemnity Plans can be added as a supplement to a MEC plan. Limited Med provides lump-sum payments for specified services such as:
- Doctor Visits
- ER for Sickness or Injury
- Outpatient Diagnostic X-ray and Lab
- Hospital Confinement
- Treatment in Intensive Care
- Mental Illness
- Substance Abuse
- Skilled Nursing
- Indemnity Outpatient Prescription Drugs
- Term Life/AD&D
Limited Med can also be a stand-alone product, but it will not satisfy the ACA mandate for ALEs.
OptiMed’s MEC plans also include non-insurance services such as telemedicine that is free and unlimited to the employee, along with a WorkPlace Wellness program, Employee Assistance Program (EAP), a Nurse Wellness Line, and COBRA administration along with Section 125 POP Plans.
Let OptiRater Lay Out Options
Constructing an employee benefits program has never been easier, now that OptiRater is available. Online and in real time, brokers can start with preventive-only MEC and then add, subtract, or reshuffle options through five buy-up plans and/or a dozen or so Limited Medical Indemnity Plans so that the employer can immediately cost:benefit analyze every option.
They can also assess adding a prescription drug plan, hearing, vision, or any other OptiMed product.
What once required days if not weeks of back-and-forth paperwork can now be achieved in just minutes. Illustrative quotes will be visible immediately online and arrive in the broker’s email within minutes.
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