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Some of the employer offered health care is not offering any coverage for out patient surgeries. Since 2 out of 3 surgeries are done at out patient clinics this will affect your pocket book. Sad part is these policies are acceptable under the ACA act. So employers get by with offering the care and the worst possible coverages imaginable. Thanks Obama
There are different minimum Federal requirements for individual plans vs small group vs large group plans
Bottom line, employers with more than 50 full time employees can avoid non- compliance penalties by offering employees the choice of a plan that includes the 10 Essential healthcare services and a Minimum Value Plan that includes preventative services and hospitalization? but excludes outpatient surgery.
The Minimum Value Plans are most common in the hospitality, casino, retail and restaurant businesses that tend to employ low wage workers. These employers tended to either not offer any insurance or junk plans before the ACA. The lower cost plans seem to appeal to both the employer and low wage employees and allow both to avoid penalties for non- compliance with the ACA.
It is my understanding that when an employee opts for the low cost plan, the employee needs to sign an acknowledgement that he/ she understands the limitations.
Some states have or intend to establish states requirements that will mandate inclusion of outpatient surgery.
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Thanks Obama
