Affordability is tested on the cheapest self-only plan, nothing else.
The test looks at the employee’s cost for the lowest-priced self-only coverage that meets minimum value. Dependents, buy-ups and richer plans do not enter it.
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One plan decides the test.
What Is Actually True
Many agencies assume the whole benefits package has to pass. It does not. The test uses only the lowest-cost self-only option that meets minimum value.
That means the plan you design for the affordability test can be modest, while richer options remain available for caregivers who want them.
What We Do About It
We identify which of your plans is the lowest-cost self-only option and confirm it meets minimum value, so the test is run on a plan that counts.
We then set the contribution on that plan to pass, and decide separately where extra agency dollars should go.
From a package to a single test plan.
What We Need
Your plan list with employee rates and the carriers’ minimum value confirmations.
What We Do
We choose the test plan and check its minimum value status.
What You Get
A named test plan and a contribution that passes on it.
Questions on this topic.
Short answers for agency owners.
What is minimum value?
A plan has it when it pays at least 60 percent of covered costs and provides substantial coverage of inpatient and physician services.
Does family coverage need to be affordable?
No. The federal test measures the employee-only cost. Family coverage cost is a business decision.
What if our cheapest plan is a high-deductible plan?
It can serve as the test plan if it meets minimum value. We check that first.
General information, not legal or tax advice. Confirm the rules that apply to your agency with your attorney or tax advisor.
Send us your renewal.
We’ll tell you whether it looks competitive, where we see opportunity, and the five questions we’d put to your carrier. No cost, and no obligation to move anything.
The renewal letter
Your current plan summary
Contribution split by tier
Enrolled counts by tier
Four documents, two more if your group is 50 or more. Nothing else; every extra one is a reason to postpone.
An independent employee benefits consulting firm. We look at the entire benefits program — cost, plan performance, risk and administration.
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