ACA Compliance Question

CATEGORY: Public Education Matters
CLIENT TYPE: Public Education
DATE: Jan 31, 2024

Question: If an employee enrolls in a private medical cost sharing plan, will it count as alternative health insurance that meets the Affordable Care Act’s requirements?

Answer: No.  A medical cost sharing plan helps individuals pay for their medical costs that are not otherwise covered by health insurance but it does not provide health insurance coverage on its own.  It is not going to meet the ACA’s requirements for providing minimum essential coverage.  Further, some public agencies offer employees cash in lieu for opting out of employer-sponsored group health insurance.  If an agency offers cash in lieu under the terms of an eligible opt out arrangement (which is recommended), then the employee will need to attest that they have alternative minimum essential health coverage for themselves and their entire tax family in order to receive the cash in lieu.  Coverage that is not health insurance, such as a medical sharing cost plan, is not minimum essential coverage and will not satisfy the requirements of the eligible opt out arrangement.


View More News

Public Education Matters
Coach’s Bullying Behavior Towards Women’s Soccer Team Could Constitute Sexual Harassment, Even If Harassment Was Not Of A Sexual Nature And Could Not Be Compared To Behavior Towards Men
Public Education Matters
Employee’s Service As A Union Officer Was Protected Activity But The District Was Justified In Terminating Her For Numerous Errors