How does an employer know that group health insurance would meet conditions needed to avoid an ACA excise tax?

[Peter Gulia]

Imagine a business that's big enough to be exposed to the excise taxes for a failure to offer sufficient health coverage but small enough that it chooses not to self-insure its group health plan.

This employer wants to know that, assuming the employer's plan provides sufficient eligibility and makes every employee's contribution low enough that all offers are affordable, the group health insurance contract it might buy would meet all other conditions so that the employer is not exposed to play-or-pay excise tax.

How will this employer know whether a group health insurance contract provides "minimum essential coverage" and "minimum value"?

Does the contract itself state that it meets those conditions?

If not, will an insurer furnish some other written assurance that the contract offered meets the conditions?

If an insurer offers a group health insurance contract that does not meet "minimum essential coverage" or "minimum value", does some Federal or State law require an insurer to furnish an affirmative warning of that fact?

[Flyboyjohn]

Almost anything (read "skinny plan" providing only preventive care) meets MEC (minimum essential coverage) so not to worry.

Virtually every fully insured plan meets MV (minimum value)and the carrier will probably not hesitate to give you a comfort letter to that effect. As you know, in the small group market the plan has to carry a Good Housekeeping type seal of approval stating it's actuarial value (minimum 60%).

The only fully insured offering I've encountered is one from Reliance Standard which is clearly advertised as being just a MEC plan and doesn't meet MV.

[leevena]

There is a variety of methods available to the employer, incluidng; purchasing a plan that the carrier has already measure, having an actuary review, or using the calculator available via the govt.

Little confused aobut your comment regading small enough to no self-insure. Am I missing something here? Why make the comment?

[Peter Gulia]

Flyboyjohn, thank you for the helpful information. And thank you for politely assuming I know more than I really do.

leevena, the point of my hypothetical is to imagine an insurance-buying employer that is less likely to have engaged an employee-benefits lawyer or an actuary, and so looks to other sources of information.