Small Businesses
Small Businesses with Fewer than 50 full time equivalent employees are not required to offer to their employees. There is no penalty for not offering benefits to their staff. To attract and retain top talent, it is critical to offer benefits to their employees. As small businesses invest in their company offering competitive benefits is critical. At Jindrich @ Associates we will a competitive plan for your employees. The Affordable Care Act has had a significant impact on the benefits we offer.
Medical Loss Ratio
The Medical Loss Ratio (MLR) was established to help control medical cost and ensure members receive value from their health care premiums. The MLR requires companies to spend 80% - 85% on their medical care. If an insurance company doesn’t spend that amount insurance companies must spend rebates to their customers. These rebates must be sent back to individual members, if they pay premiums for their health premiums.
Patient Bill of Rights
The ACA contains mandates for health plans regarding pre-existing conditions, lifetime maximums, rescissions and other patent protections. Effective September 23, 2010, group health plans can no longer have a lifetime maximum benefit. All Healthcare plan must cover the 10 essential health benefits. Also, insurance companies can no longer cancel coverage, unless there is fraud or intentional misrepresentation of a material fact.
90 Day Waiting Period Limit
Effective January 1, 2014 the ACA prohibits group Health Plans that exceed 90 days. This law effects plans that are both Grandfathered or Non Grandfathered plans. To meet the new requirement for groups that had a 90 day or longer waiting period, they had to adjust to benefits being offered on the first of the month following 60 days.