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Coverage Adequacy Service

With the employer shared responsibility (ESR) provisions' coverage and reporting requirements in place, you as an employer face a complex and difficult task in assessing the coverage you offer your full-time employees. You are required to:

  • Determine the number of full-time employees you have, including full-time equivalent employees (i.e. seasonal and part-time employee work hours that total a full-time employee's)
  • Test your coverage to see if it meets minimum quality and value standards as defined by the ESR provisions
  • Assess whether the coverage you offer is "affordable," according to your employees' wage data

BeneTrac's Coverage Adequacy Service provides a proactive tool to help clients meet the coverage adequacy standard through reporting solutions that offer:

  • If you are an applicable large employer (ALE), you must make the choice to offer coverage to your full-time employees and their dependents, not including spouses, or make a shared responsibility payment to the government on behalf of each full-time worker
  • Testing of current coverage for minimum essential coverage (MEC) and minimum actuarial value (MAV)
  • Affordability assessment, using all three affordability safe harbors to compare your current health insurance coverage data against your full-time employees' wage data
  • Calculation of any potential ESR penalties you face
Coverage Adequacy