Minimum Essential Coverage (MEC) plans cover preventive services like vaccinations and screenings to satisfy the part A requirement under the Affordable Care Act (ACA) or 4980H(a). While a Minimum Value Plan (MVP) covers at least 60% of the actuarial value of allowed benefits - similar to a bronze-level plan available on a public Exchange. MVP can satisfy the part B requirement under the ACA or 4980H(b).
Simple and Affordable Fully ACA Compliant Benefits
Crucial ACA Problem
Costly ACA fines can derail you from achieving your business goals
4980H(a) Penalty
$2,900 / employee
The 4980H(a) penalty, commonly referred to as the “sledgehammer penalty” due to its pass-fail nature, is issued when an employer fails to offer Minimum Essential Coverage (MEC) to at least 95% of its full-time workforce, and one or more of those employees receives a Premium Tax Credit (subsidy) for coverage through the Health Insurance Marketplace.
4980H(b) Penalty
$4,350 / employee
The IRS issues a 4980H(b) penalty when an employer fails to offer affordable, Minimum Value (MV) health coverage to a full-time employee during the tax year, and that employee receives a Premium Tax Credit (subsidy) to purchase insurance through the Health Insurance Marketplace. Each full-time employee who receives a subsidy can trigger an ACA Section 4980H(b) penalty for the employer.
Once your business hits the threshold of 50 full-time or full-time equivalent (FTE) employees, failing to comply with the ACA's employer mandate can result in costly IRS penalties that could drastically impact your organization.
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Vitable MEC and MVP
Your ACA Compliance Solutions
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01
Part A Compliant Plans
- Compliance against ACA part A fines
- Coverage for essential preventative care services
- Includes direct primary care for employees and their families
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02
Fully Compliant Plans
- Compliance against ACA part A & B fines
- Coverage for catastrophic services like hospitalizations & specialists visits
- Includes direct primary care for employees and their families
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Common mishaps that lead to ACA fines
Confusion around ACA obligations
Overwhelming insurance information
Failure to properly track FTEs (full-time-equivalents)
Rapid, unmanageable employee growth
With all this to worry about, it’s no wonder why maintaining ACA compliance is so difficult. Unfortunately, the IRS doesn’t care. But Vitable's got you covered!
Compliance solutions that outperform the competition.
Affordable and fully ACA compliant plans (part A & B)
Includes Vitable Primary Care coverage with $0 copays
1,000+ free prescriptions from Vitable Primary Care
Low minimum enrollment requirements
Managed open enrollment periods
Managed IRS Tax Filings
Custom Plan Designs
Mental Health Coverage
Dedicated Mobile App
Dedicated Customer Success Support
Employer Dashboard for Benefit Management
Assess your ACA penalty risk
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Frequently Asked Questions
What is the difference between MEC and MVP?
What is Applicable Large Employer (ALE)?
An Applicable Large Employer (ALE) is a business or organization that has an average of at least 50 full-time employees or full-time equivalent employees (FTEs) based on the preceding year. An applicable large employer may be a single entity or may consist of a group of related entities. If there is a group of related entities, these are referred to as ALE members. ALEs are subject to specific provisions of the Affordable Care Act (ACA), including employer shared responsibility rules and reporting requirements.
How do I calculate Full-Time Equivalent Employees?
A full-time equivalent employee is a combination of employees, each of whom individually is not a full-time employee, but who, in combination, are equivalent to a full-time employee. An employer determines its number of full-time-equivalent employees for a month in the two steps that follow:
1) Combine the number of hours of service of all non-full-time employees for the month but do not include more than 120 hours of service per employee, and 2) Divide the total by 120
You can find more information at the IRS ALE page: https://www.irs.gov/affordable-care-act/employers/determining-if-an-employer-is-an-applicable-large-employer
What are §4980H "Offer of Coverage" requirements?
The offer of coverage requirements for ALEs under §4980H are as follows:
§4980H(a) – ALEs must offer minimum essential coverage (MEC) to at least 95% (or all but 5, if greater) of full-time employees and their dependent children each month. An offer of coverage is not required for spouses.
§4980H(b) – ALEs must offer coverage that provides minimum value AND is affordable to all full-time employees each month. There is not a 5% “margin of error” for §4980H(b) requirements like there is under §4980H(a).
Does Vitable's ACA Compliance Solutions fully meet the ACAs requirement?
Vitable ACA Compliance Solutions are intended to comply with at least some ACA requirements, to the extent that an employer requests modifications to plan administration or revises plan documentation, the plan may not comply or may not comply fully with the ACA. In addition, Vitable helps employers comply with the ACA and helps employers avoid ACA penalties, but Vitable is not a legal advisor and recommend that employers consult with counsel regarding compliance with laws and regulations.