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Workplace Challenges in 2015, Part 3 of 5: Beware of Stop-Loss Coverage Gaps When Choosing a Self-Funded Major Medical Plan

Recently, Mintz Levin held a seminar in New York City that addressed some of the major challenges employers are facing in the New Year.  Our program contained segments on New York City’s paid sick leave law, effective management of HR Issues, the Affordable Care Act, employment practices liability insurance coverage, and workplace privacy.  Over the next few weeks we will be posting a series of entries following up on the critical workplace issues raised during these segments.

Today’s topic: Continued Coverage Issues Under the Affordable Care Act

Mintz Levin’s Alden Bianchi, and Jim Essey, Chief Executive Officer of the TemPositions Group of Companies, presented on a variety of issues that have arisen under the ACA’s pay-or-play rules and discussed some compliance strategies.  One issue that came up concerned coverage of variable, contingent and temporary workers – usually employed through staffing companies, restaurants, retail, etc.

Historically, those employees were not offered coverage because of the short-term and unpredictable nature of most temporary work, the low rates of employee participation in health insurance plans, and the potential that those who do elect coverage will disproportionately be older or sicker (adverse selection).  But now many of these same employers will have to offer affordable coverage to these works or face penalties.  As a follow-up to the discussion at the event, Alden, along with Mintz Levin senior advisor Edward A. Lenz, have prepared a white paper that focuses on a self-funding insurance coverage option and stop loss coverage gaps when selecting that insurance option.  The white paper can be accessed here.

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