Large employers (employers with 50 or more full-time employees) have a unique challenge when it comes to offering employee benefits. Under the Affordable Care Act (ACA), large employers are required to offer employees a group plan that meets minimum standards. This is called minimum essential coverage (MEC).
A MEC plan is a group plan that meets these minimum standards. By offering Gravie and a MEC plan, you can reduce or eliminate costly penalties/payments (check our post: Dissecting the ACA Employer Shared Responsibility Payments ) while giving your employees and their dependents access to hundreds of plans and more choice than you ever could with a group plan. (Check out our post Are Your Employees Parked in a Group Health Plan Wasteland.)
Unlike other group plans, with the Gravie MEC plan there are no minimum participation requirements. Most of the time no employees will enroll in the MEC plan because of better options available in the individual market. Additionally, the Gravie MEC plan is 100% employee funded. Typically, no employer money is applied towards the cost of the plan.
Gravie administers the MEC plan as Gravie Administrative Services LLC. A monthly administrative fee is charged per enrolled employee and the fee is built into the premium. Our solution is compliant with state and federal law. We stay on top of changing regulatory requirements so you can focus on your business. Regardless of enrollment in the plan, Gravie maintains and provides these services:
- Acting as the licensed third party administrator on the employer’s behalf.
- Assisting the employer in establishing a self-insured ERISA plan that complies with ERISA and ACA requirements. We monitor, evaluate and update all plan information with relevant requirements.
- Consulting services on the benefit design of the MEC plan to limit exposure to the IRS Employer Shared Responsibility penalties. As the federal requirements for the MEC plan change, Gravie updates all applicable documents and reporting components.
- CMS Section 111 reporting – quarterly electronic reporting of eligible employee SSN to CMS on behalf of the employer.
- Customized ERISA and ACA compliant plan documents. We update all applicable documents as required.
- Compliance with six distinct Federal Employee Notification requirements. We update all notification packets and documents as required and issue notices to meet initial and annual regulatory notification timeframes.
- Department of Labor compliant claims and adjudication process on behalf of the employer, including compliant employee adverse benefit determination notices.
- Contracted with an EDI vendor to process electronic transactions in compliance with HIPAA security requirements on behalf of the employer.
- Contracted with three independent External Review Organizations to handle external appeal requests.
- Contracted with a language translation line to comply with ACA’s “culturally and linguistically appropriate” requirements.
- Administration of an internal appeals process on behalf of the employer.
- Year-round contracting with a national provider network on behalf of the employer.
- Advisor support and consultation to all employees related to MEC plan coverage.
The ACA can be confusing and failing to comply with ever changing rules and regulations can be time consuming and costly to your business. Gravie’s here to help. Call us at 844.540.8701, fill out our employer form, or tweet us @gogravie.