Large Group and 30hrs Per Week...

[NWBenefitProvider]

I need some clarification please. Is there a CURRENT mandate for 2014 that requires large employers to offer coverage to employees working at least 30 hours per week?

Some carriers are saying yes, others no. I'm trying to get the straight scoop. Anyone?

 

[elisag2a]

If you write any new policy either large or small the carriers are requiring you to offer coverage to all employees working 30 hours or more.

 

[Quotebroker]

If you write any new policy either large or small the carriers are requiring you to offer coverage to all employees working 30 hours or more.

To finish the thought:

...but you don't HAVE to offer in the first place.

 

[leevena]

To finish the thought:

...but you don't HAVE to offer in the first place.

Qutoebroker is correct, PPACA 30 hour requirement is not required until 1/1/2015. The delay did not affect other provisions, such as; ban on dollar limits, pre-existing conditions, 90 day waiting period, OOP limits, PCORI, contraceptive, employee notification of exchanges, and a few other things.

 

[NWBenefitProvider]

Qutoebroker is correct, PPACA 30 hour requirement is not required until 1/1/2015. The delay did not affect other provisions, such as; ban on dollar limits, pre-existing conditions, 90 day waiting period, OOP limits, PCORI, contraceptive, employee notification of exchanges, and a few other things.

Ok, now you've really got me confused. No mandate I get. no longer than 90 day waiting period I get.

If I am a large employer and DECIDE to offer coverage to my employees. Do I have to offer it to everyone who works 30+ hours per week, or can I still decide what hour requirement they must meet, not to exceed 40hrs per week?

This is what I am getting conflicting answers on. Above in the string they state have to offer it to 30hr+, but some carriers here are saying you can still elect up to 40????

 

[leevena]

Sorry for the confusion. Legally you do not have to worry about the 30 hrs stated in ppaca, so you can use another (32, 40) hours requirement. What I dont know is what your carriers are requiring from an administrative requirement. It is possible that this may be an administrave requirement. Hope this helps

 

[thebig_j]

I'm quoting an employer with 125 ee's right now and he's only offering the Management and home office staff about 18 people. I believe these are all salary positions. Haven't even talked about hours that much.

If I understand correctly. This would be an example to answer your question.

 

[NWBenefitProvider]

Sorry for the confusion. Legally you do not have to worry about the 30 hrs stated in ppaca, so you can use another (32, 40) hours requirement. What I dont know is what your carriers are requiring from an administrative requirement. It is possible that this may be an administrave requirement. Hope this helps

Thanks. It makes sense now. Carriers are fine with an employer using anywhere from 20-40 hours for eligibility. I did, however start to wonder since hearing other agents warn about having to extend benefits to everyone at 30 or more hours per week. I just wanted to confirm my original thought that they indeed still maintain control of eligibility. Thanks.

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I'm quoting an employer with 125 ee's right now and he's only offering the Management and home office staff about 18 people. I believe these are all salary positions. Haven't even talked about hours that much.

If I understand correctly. This would be an example to answer your question.

Yes, I see that because the nondiscrimination rules are not being enforced right now it makes options like this easy to do. I'm looking at a similar group right now with about 200 total ee's, but only 70 are eligible based on working full time and of those they only had 24 sign up for the plan. They are trying to boost participation, but the majority of their staff are janitors working for low wages, so they aren't too keen on parting with what little they earn. It's a little bit of a tough one and I'm not sure I'll be able to bring the best proposal to the table. Thinking the strongest regional HMO to get their costs down and hope for the best.

Good luck with your new group.

 

[thebig_j]

Are they healthy enough to self fund?

 

[NWBenefitProvider]

Honestly, I haven't really explored self funding much. In the past it wasn't enough savings to the groups or it just wasn't a good fit. I'd like to explore the option more, but really need to be guided through it by someone with experience. I have yet to find that person in my area to work with.