The Future of Employee Benefits
Trends and Projections
What does essential health mean?
Minimum essential coverage is health insurance coverage that satisfies the Affordable Care Act‘s guidelines. Although there is no longer a federal penalty for not having minimum essential coverage, the individual mandate still exists and the concept of minimum essential coverage is still important.
Plans that qualify as minimum essential coverage include employer-sponsored plans, individual major medical plans (including new ACA-compliant plans, grandfathered plans, TRICARE, Medicare, most Medicaid plans, and a few others.
10 Essential Health Benefits
Preventive Care... What does that mean?
Preventative care is health care that prevents disease, injury, or illness, rather than treating a condition that has already become catastrophic or acute. The goal of preventive care is to help people stay healthy.
Preventive care can be different based on age and gender. To see a full list of preventive care we have included a helpful link below. To see if a service you are inquiring about is considered preventive, check out our link below!
Enrolling In A Plan
Open Enrollment
Open Enrollment is a specific timeframe every calendar year when you can sign up for health insurance.
If you do not sign up for health insurance during open enrollment, you typically cannot sign up for insurance until the next open enrollment period, unless you what’s called a qualifying event.
Special Enrollment Period
Special Enrollment Periods, also known as a Qualifying Life Event – are an event that triggers a special enrollment period for an individual or family to purchase health insurance outside of the regular annual open enrollment period.
Examples of Qualifying Life Events Include:
- Losing health insurance for any reason except not paying premiums
- Losing eligibility (Medicaid, or a Children’s Health Insurance Program)
- Turning 26 and losing coverage through a parent’s plan.
- Loss of job-based coverage (quit or fired)
- Marriage, divorce, or legal separation
- Pregnancy, adoption of a child, or any adding of dependents.
- Losing coverage due to a death in the family
- Moving to a different coverage area.
- Changes in income that affect the coverage you qualify for.
- Becoming a US Citizen
- Released from incarceration
- Losing coverage due to your spouse retiring.
Metal Teirs
Gold
Plan- 20% Consumer
- 80% Insurer
Silver
Plan- 30% Consumer
- 70% Insurer
Bronze
Plan- 40% Consumer
- 60% Insurer
Metal tiers are a quick way to categorize plans based on what that split is. Some people get confused because they think metal tiers describe the quality of the plan or the quality of the service they will receive, which is not true.
Advanced Premium Tax Credit (APTC)
The advanced premium tax credit reduces the amount you pay for monthly health insurance premiums if you bought your insurance on the Marketplace. The amount of the credit is determined by your income. It is calculated and sent directly from the federal government to insurance companies.
What The Heck Is MNsure?
MNsure is Minnesota’s health insurance marketplace where individuals and families can shop, compare, and choose health insurance coverage that meets their needs. MNsure is the only place you can apply for financial help to lower the cost of your monthly insurance premium and out-of-pocket costs.
At Schatz Benefit Group, we believe that knowledge is power. Join us as we take a dive deep into the latest developments and trends with employer benefits. Stay ahead of the game by understanding how these trends impact the bottom line your business.
Join us as we discuss the latest developments in the Minnesota Paid Family & Medical Leave Law. Gain valuable insights on how this transformative law will affect your organization, discover projected costs, and understand the additional filing requirements. Click the date below to register!
As the President and Owner of Schatz Benefits Group, I wanted to create an agency that was more than just a business. I wanted to create an extension of my family. My goal is that my team, referral partners and customers feel the love, time, and effort I put into my work. My passion is building long term relationships and helping others. I hope that with each phone call, email, and face to face interaction you feel valued and appreciated.