You're an Applicable Large Employer

Tara Lofley
Feb 11
2 min read

That means you live by the ACA's rules: Minimum Essential Coverage (MEC), Minimum Value (MV), affordability, and accurate IRS reporting (1094-C/1095-C). Right now, the traditional insurance model is draining your budget while still leaving you with the compliance risk.

Traditional insurance is "fully insured," meaning the ALE pays a massive premium and the insurance company keeps the profit if the employees stay healthy. We use a proactive Care Coordination to steer employees toward high-quality, fair-priced providers.

For an ALE with 100 employees, preventing just one unnecessary ER visit or overpriced MRI through Coordination saves the plan thousands directly. We handle the COBRA administration and tax reporting as part of our plans.

It offloads the HR headache, allowing businesses to focus on growth. We provide ACA-Compliance for Tennessee and Kentucky Employers.

Minimum Essential Coverage:

At Blue Ocean Employer Benefits, we focus primarily on 100% coverage for preventive services, like checkups and screenings, as required by law. We also include prescription drug benefits and telemedicine access.

Planstin offers 2 distinct MEC plans within its Preventive Health Plan suite:

1. Preventive HSA

2. Preventive Copay

Minimum Value Plans:

To qualify as providing Minimum Value, a health plan needs to cover a minimum of 60% of the overall plan costs and include a broad range of medical services, including inpatient and outpatient surgery, maternity care, and emergency and urgent care. Basically, the plan needs to foot the bill for the majority of the insured medical costs, and the employee pays the rest through deductibles, copays, and coinsurance.

Planstin offers 5 minimum value plans through our Care+ Series.

While these health plans may be offered to any employer group, there are qualifications that need to be met depending on group size as follows:

GROUPS UNDER 50 may offer Care+ with minimum participation of 5 employees or 75% of their full-time employees (whichever is higher)

GROUPS OVER 50 may offer Care+ and MEC plans with a minimum participation of 95%