Coverage Tabs

What is the Coverage Tab used for?  

The coverage tab is designed to provide you information regarding the individual’s medical election, affordability safe harbor, and the lowest annual cost that the employee was eligible for.  The Coverage tab can be used to confirm information at the employee level to ensure the offered medical plans are considered “affordable” under the ACA guidelines.

Coverage Level
The Coverage Level field will display what the employee elected, including the Package Name, Benefit Name, Plan Name, and the Coverage Level

Date Range 
The date range will display the range of the employee's election.

Qualified Health Coverage
The Qualified Health Coverage field will display a green check-mark when the elected medical plan meets Minimum Essential Coverage

This information can be confirmed in the benefit structure (Settings > Benefit Management > click into package > click on “Step 2-Configure Benefit Structure" > click into applicable medical plan > scroll ~half way down the screen to see if “This plan meets Minimum Essential Coverage (MEC) as defined by the ACA” is checked off.

9.5% of Rate of Pay
This field will show what 9.5% of the employee's Rate of Pay is if configured, and can be used to determine affordability against the "EE Only Lowest Cost" field.

9.5% of W2 Earnings
This field will show what 9.5% of the employee's W2 is if configured, and can be used to determine affordability against the "EE Only Lowest Cost" field.

9.5% of Poverty Level
This field will show what 9.5% of the Federal Poverty Level (this is hard-coded in the system and does not require configuration). This field can also be used to determine affordability against the "EE Only Lowest Cost" field.

Annual Employee Cost
The Annual Employee Cost displays the annual cost the employee will or is paying for the plan they elected.

ProTip: this field is strictly informational and should not be used to determine affordability because the employee may have elected a waive plan, or a plan that is costlier than the lowest cost offered.

EE Only Lowest Cost
To see the lowest employee-only medical coverage cost available to the employee, click on "Click to Show Details" link under the EE Only Lowest Cost header. This can be used to help users confirm if their lowest paid employees offering is considered affordable under the ACA.

ProTip: figures shown in the Coverage section of the ACA Profile are Annual rates and should be divided by 12 to display monthly rates.

 

 

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