At Ternian Insurance Group, we always consult with our own ACA experts as well as those in the industry before recommending any particular solution. As the buzz around one approach has increased—the carve out of essential benefits using a “loophole” in the CMS essential value calculator—we have approached this idea with a healthy amount of skepticism.
To evaluate this issue, we have conducted extensive research which reveals that these plans are:
- High-risk: Employers could face thousands in ACA penalties down the road, costs not covered by a broker’s E&O insurance. Employers must also certify these plans as MVPs through IRS Form 1095 C, leaving them vulnerable to litigation if employees experience high balance bills.
- Medium cost: These plans are more expensive than MEC/limited-benefit packages.
- Low value: In many cases, MEC/limited benefits actually provide greater value to employees.
Download our positioning paper on the Minimum Value Calculator Loophole today for insights, claims scenarios and expert perspectives that will help you better understand this issue.
Ternian Insurance Group