A company has developed a group mini medical program designed for the Affordable Care Act (ACA) age.
The company, Coterie Advisory Group Inc. of Scottsdale, Arizona, says its new Fundamental Care health plan will provide affordable, no-deductible health coverage.
(Related: How Minimal Can ACA-Required Coverage Be?)
The plan keeps costs low by providing coverage that’s solid enough for workers to avoid having to pay any ACA “individual shared responsibility” penalties, but too limited for employers to use the coverage to avoid paying ACA “employer shared responsibility” penalties.
‘Minimum Essential Coverage’ and ‘Minimum Value’
The ACA requires many people to have what the government classifies as “minimum essential coverage” (MEC), or solid major medical coverage, or else pay a penalty.
Almost any employer-sponsored coverage that covers certain preventive care services can qualify as MEC.
The ACA also requires many employers that are classified as large employers to provide MEC with a minimum actuarial value or else pay a penalty.
The minimum value is about 60% of the actuarial value of the cost of a state’s “essential health benefits” package, or standard benefits package,
For now, Congress has set the individual shared responsibility penalty for individuals at $0.
Employers affected by the employer coverage mandate may still have to pay employer shared responsibility penalties if their permanent, full-time employees apply for coverage through the Affordable Care Act public exchange system and end up qualifying for premium tax credit subsidies.