Small or Large? Determine Your Client's Size
The medical carriers no longer count how many employees are eligible for the benefits, nor do they count how many enroll in the medical plan when deciding how a group should be rated.
Instead, the carriers use the group's Total Average Employee (TAE) count to determine whether a group is rated as a small employer (2-50) or a mid/large employer (51+). Any Pennsylvania group that has employed, on average, 51 or more employees during the preceding calendar year will be considered a large employer for the purposes of rating.
The ACA defines an employee as any person for whom the company issues a W-2, and this includes full-time, part-time and seasonal workers who may or may not have been eligible for the employer's medical plan. This does not include 1099 independent contractors.
If you are uncertain as to how your client should be rated, have them complete the Employee Count Forms provided below.
Small Employer Quote (2-50 TAE)
Due to the changes from the Affordable Care Act, you will now need to provide a member level census containing the demographics of ALL enrolling subscribers and dependents in order to obtain health insurance proposals for your clients.
We've modified our Group Quote Request Form to assist you with capturing the proper data.