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ALEs and Employee-Only Coverage

ALEs and Employee-Only Coverage

By Catrina Reyes, J.D., M.P.A., Policy Analyst and Compliance Manager, Jan 27, 2016, < 1 Minute Read

An Applicable Large Employer (ALE) may be meeting its Large Employer Mandate obligation to offer Minimum Essential Coverage and a Minimum Value plan, but are they certain they are offering coverage to all eligible employees and dependents? If your client has selected an employee-only coverage plan, the employer may be exposing their business to a penalty. While the employer does not need to contribute towards the cost of dependent coverage, they are required to offer coverage to dependent children.

The Society for Human Resource Management (SHRM) states that dependent status under the PPACA is based on the relationship between a child and a participant and that a large employer that fails to offer coverage to employees’ dependents is not meeting the ACA requirements for coverage and therefore subject to an assessable penalty.

Did you know groups with substantially fewer than 50 employees may be an ALE?
If you have ALEs in your book that are on employee-only coverage, we can assist those groups written with Covered California.

To learn more about the Large Employer Mandate and how to identify Applicable Large Employers, download our essential ‘Play or Pay’ guides.

Questions?
Contact the small group experts at 800.696.4543 or info@claremontcompanies.com.