Help for those affected by the hurricanes | Learn More

A message from Aflac

To our policyholders in areas affected by the recent hurricanes, please know that the thoughts and prayers of everyone at Aflac are with you. We are working with government agencies that represent all declared disaster areas to ensure we do everything possible to help you. Based on that guidance, we have extended the due dates for policy premiums by 60 days for those living in places that have been declared disaster areas. If you have a question about your policy or need help, contact us at 800-992-3522. To help with the recovery, Aflac made a $500,000 donation to the American Red Cross, and our employees are making their own private contributions. Please be safe, as the care of you and your families is paramount.

Businesses with fewer than 50 FTE employees

What you need to know and do to prepare for benefits open enrollment season

Benefits requirements

Though companies with fewer than 50 full-time equivalent employees aren’t required to offer them, if they offer major medical coverage, it must:

  • Cover at least 60 percent actuarial value.
  • Include essential health benefits.
  • Provide certain preventive services at no cost to employees.
  • Set limits on cost-sharing.

When it comes to benefits requirements, keep the following in mind:

  • Required communication

    Employers are required to provide notice about health insurance marketplaces to all new employees within 14 days of hire. Learn more

  • Benefits waiting periods

    Keep enrollment waiting periods to 90 days or less.

  • Summary of benefits and coverage

    If your company offers major medical insurance benefits to its workforce, a summary of benefits and coverage must be provided to all major medical insurance applicants and enrollees before benefits enrollment or re-enrollment. The SBC must provide an accurate description of the benefits and coverage under the applicable plan or coverage.

  • Keep track

    Employers are responsible for keeping detailed records of employment status and hours worked by their employees. Tracking involves important details for full- and part-time employees issued by the federal government, including measurement periods and reassessment.

  • COBRA notifications

    If your company offers a group health plan, exiting employees must receive a COBRA notification that includes information about health insurance marketplaces. Learn more

Out-of-pocket and contribution limits for 2017

wallet icon

Out-of-pocket limits for ACA compliant plans:

$7,150 – individual coverage
$14,300 – family coverage

wallet icon

Out-of-pocket limits for high-deductible health plans:

$6,550 – individual coverage
$13,100 – family coverage

coins/money icon

Health savings account contribution limits:*

$3,400 – individual
$6,750 – family

coins/money icon

High-deductible health plan minimum deductibles:

$1,300 – individual coverage
$2,600 – family coverage

*Catch-up contributions up to $1,000 can be made any time during the year in which the health savings account participant turns 55.

money in shirt pocket icon

Out-of-pocket limits

Out-of-pocket limits reflect the most an individual or family will pay for covered essential health benefits before their plan begins to pay 100 percent of the costs. Prepare for out-of-pocket expenses by learning about what counts – and what doesn’t count – toward the established limits.

Watch Video

Penalties

The shared-responsibility penalty is for large employers that do not offer health insurance to their full-time employees and their dependents under the age of 26. Under the Affordable Care Act, companies with fewer than 50 full-time equivalent employees aren’t penalized for not providing employee benefits coverage.

clipboard / check list icon

Required reporting

Your company won’t need to submit IRS reporting for employer-sponsored health care coverage. But if you offer benefits through a self-funded health plan, you’ll need to submit minimum-essential coverage reporting annually.

Minimum Essential Coverage Reporting Aflac business solutions

The Cadillac tax

The Cadillac tax, scheduled to take effect in 2020, is equivalent to 40 percent of the cost of health coverage beyond a certain threshold, depending on the type of plan. It’s important to wait for further guidance as 2020 draws near – including the tax threshold amounts and other implementation details.

Anatomy of the Cadillac Tax Cadillac Tax FAQ
Everwell - benefits simplified logo

How Everwell can help

Benefits administration platforms, like Everwell powered by Aflac, offer multiple benefits options and a variety of voluntary products, including vision, dental, disability, accident and much more. They offer exchange-facilitated enrollment and help coordinate between multiple carriers, which can help businesses save on administrative costs. Contact your Aflac agent to learn more.

Aflac duck pointing wing left

How Aflac can help

Aflac is not major medical insurance. Aflac insurance policies don’t replace comprehensive health insurance coverage. These benefits are considered HIPAA excepted benefits, which are excluded from most of the ACA’s market reforms. Because of this, having voluntary benefits options is a smart way for businesses to enhance their employee-benefits packages.

View Details
  • Aflac is for specified injuries, illnesses or disabilities. For example: a broken arm, heart attack or hospital stay. Relevant policies include supplemental life, disability, critical illness, hospital, accident, cancer insurance and much more. These benefits pay cash to help cover bills and out-of-pocket costs not covered by major medical insurance.
    • Aflac helps cover out-of-pocket costs that major medical insurance was never designed to cover. Even with major medical insurance, potential out-of-pocket costs associated with illness or injury can be considerably high. Aflac cash benefits can be used to help with everyday living expenses such as rent/monthly mortgage, utilities, groceries, child care, or out-of-pocket medical expenses. When policyholders are sick or hurt, Aflac pays them cash benefits to use however they want so they can focus on recovery, not financial stress.

Make Aflac part of your benefits package today. Contact your agent or contact Aflac today.