Basic medical coverage is a big deal, especially to the millions of workers across the nation in hourly service jobs like staffing, retail, restaurants, and hospitality. In the last three years, employers have been mandated to make such benefits available and are required to comply with Affordable Care Act (ACA) regulations.
But offering affordable and meaningful benefits are not always the same. Meaningful benefits are no deductible plans, small copay plans, and first dollar benefits — plans that cover the day-to-day expenses and give hourly and lower-waged employees real access to care at an attainable cost.
Recommended For You
Let's break down the numbers:
-
Doctor visits may cost $180
-
A wellness visit for children can range from $500 to $800 without insurance
-
Filling prescriptions may cost $300 or more a month
-
An emergency room visit has a price tag of $1,500
These are expenses workers making $10 to $14 per hour just can't afford. The alternative is a high-deductible health plan (HDHP) that only covers catastrophic expenses, which less than 3 percent of Americans will ever use.
In the absence of a better option, many go without care. They don't get their checkups; they go without needed prescriptions; they use the ER as a doctor's office because they simply can't afford a traditional health plan or the out-of-pocket costs associated with a traditional HDHP.
For years, some employers and business owners have been able to ignore benefits simply because it wasn't necessary to attract and retain employees. Today the quality of your staff can hinge on the ability to offer meaningful benefits. So what does that look like?
Prior to the ACA, many companies leaned toward limited-medical benefit plans as a solution to providing affordable benefit alternatives that were meaningful to their employees as an attraction and retention tool. These benefits could be offered with or without an employer contribution, making it more than affordable at the employer level.
The ACA, however, prevents employers from continuing down this road. Limited-medical benefit plans by themselves are no longer considered compliant, but coupled with a minimal essential coverage plan (MEC), employers can continue offering those benefits by adding an ACA compliant component.
The addition, non-traditional minimum value plan (MVP) created a second level of protection for the B Penalty of ACA. Both options make the employee compliant and help the employer offer meaningful and affordable benefits to their employees while avoiding costly ACA penalties.
The last three years has provided the industry time to refine and build out these ACA compliant plans to ensure they fit the needs of employees and the budgets of employers. The fact is that these solutions are a big deal, so choosing the right one is vital to the health of employees and the health of the business.
© 2025 ALM Global, LLC, All Rights Reserved. Request academic re-use from www.copyright.com. All other uses, submit a request to [email protected]. For more information visit Asset & Logo Licensing.
