I am seeking advice regarding Applicable Large Group offering affordable coverage to employees.
My ALE group in New York will offer health insurance coverage with minimum value (a Bronze level plan) starting this June. The required annual contribution from the staff for this plan will not exceed 9.5% of the W2 wages of each worker (even for lowest wage worker for the company). The group also gave the choice to the workers to get a Silver level plan but the annual contribution will exceed 9.5% of their W2 wages.
It turns out none of the staff want the Bronze level plan but they all chose the Silver plan and be willing to pay more contribution. Because of the fact that no subscriber will be taking the Bronze plan, the insurance company refused to open the plan without subscriber in it.
I explained to the insurance carrier that the Bronze plan must be installed for this ALE to meet the affordability definition and to be readily available to any future new hire. In addition in case of audit the employer must prove that they have a plan which is affordable.
Did I interpret the regulation correctly? If the insurance company continues to refuse installing this Bronze plan is it not true that the employer must increase their contribution to the Silver plan for the new hire (or readjust the contribution from employee to the Silver plan) to make the plan "affordable" since this is the lowest cost plan available?
I appreciate your insight and comment in advance. Your prompt reply is greatly appreciated!
Regards,
Tony Wong
MBA, LUTCF
NAHU Member