Questions and Answers regarding the Employee Contribution Information Form
What is the purpose of this form?
What groups or employers were sent this form?
What is the deadline for returning this form?
What if the employer does not complete and return the Employer Contribution Information form?
Can the employer decrease the health insurance contribution rate?
Are employers prohibited from increasing the health insurance contribution rate?
Are education entities required to include the contribution paid by the state when figuring the employer’s contribution rate?
If the employer’s contribution rate is based on the HealthChoice High Option Plan premium, how should this information be indicated on the form?
If an employer provides a specified amount, for example $500, for the employee to use toward their insurance premiums for all benefits but does not pay anything for dependent coverage, how should that be indicated on the form?
What is the “Employer ID #”?
HealthChoice is maintaining grandfathered health plan status as it relates to the Affordable Care Act. In order for HealthChoice to keep this status, participating employers cannot decrease their employees’ insurance contributions for plan year 2011 by more than 5 percent of the contribution rates that were in effect on March 23, 2010. Reductions that are based on existing formulas or percentage rates that were in effect on March 23, 2010 are excepted from this requirement (i.e., employers who contribute 75% to the cost of employee insurance).
A: Employers must use this form to report their contributions to employees’ insurance rates effective on the following dates: March 23, 2010 and January 1, 2011.
A: All education, county, local government, community action committee, rural water district, and other non-EBC employers.
A: The deadline is November 1, 2010. If the form is not received by the deadline, a second letter will be sent to the employer.
A: Each employer is required to complete and return this form. Failure to comply can result in the termination of a group’s participation through OSEEGIB effective January 1, 2011.
A: Yes, as long as the decrease in the health insurance contribution rate is less than 5% of the contribution rate that was effective March 23, 2010. It is not considered a decrease in the contribution rate when the decrease results from a formula or percentage rate that was in effect on March 23, 2010.
A: No. Employers are allowed to Increase contribution rates. An increase in contribution rates will not affect the grandfathered status maintained by HealthChoice.
A: Yes. Employers’ contribution rates should include the total amount paid toward their employees’ insurance premiums.
A: If the contribution rate fluctuates annually based on the amount of the HealthChoice High Option Plan premium, the IC should circle HealthChoice High Rate on the response form. If the employer pays a percentage of the HealthChoice High Option Plan premium, the IC should circle Other and enter “xx% of HealthChoice High Rate” in the space provided.
A: The IC should circle Other on the employee health line and enter “Pays up to $500.00 toward all benefits” in the space provided. On the subsequent employee benefit lines, circle Other and enter “Included in benefit allowance stated above.” Circle None on all dependent benefit lines.
A: The Employer ID # is the employer tax identification number (TIN).
Note: To complete the form, the IC can circle one of the available options, i.e. Total Premium, HealthChoice High Rate, None, or Other, on the line instead of filling in dollar amounts. Additional information regarding completing this form will be provided as it becomes available.