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IT’S HERE: A BRAND NEW WAY TO OFFER GROUP HEALTH BENEFITS!

For Utah-based small employers (2-50 employees) Avenue H is available as a viable option! A qualified Utah insurance agent / producer can assist you during this limited launch.

WHY DEFINED CONTRIBUTION?

Simplified Benefit Management: Defined contribution plans greatly simplify the planning and management of a company’s health benefit options. By enrolling in a defined contribution plan via The Exchange, the only decision an employer has to make is how much to contribute towards each employee’s health benefit. Employers will no longer be responsible to choose between multiple plans, insurance companies, and provider networks.

Predictable Costs: By electing to make a defined contribution rather than choosing a company-wide health plan, employers can predict and contain health benefit costs.

Expand Benefit Offerings: Enrolling in a defined contribution plan via Avenue H also allows employers to offer greatly expanded health plan options to their employees. Employees will use The Exchange to compare plans, providers, and select the option best tailored to their individual needs; no more one-size-fits-all benefits packages.

Offering a tailored health benefit will help businesses attract and retain high-quality employees in a competitive marketplace. It allows employers to offer “big company” benefit options regardless of their size.

Preserve Tax Benefits: A defined contribution plan also allows employers to continue to offer the tax benefits of an employer-sponsored plan. Employees can pay their portion of their health premium with pre-tax dollars, which reduces the employee’s taxable income and also reduces the employer’s FICA obligations.

In an effort to provide you with the best possible experience and to ensure the enrollment process is completed without any problems we are requiring that participants work with an insurance agent / producer with Defined Contribution experience.

  1. Which employer groups are eligible to participate in the defined contribution system? What group size will the Exchange accommodate?Employers in Utah with group size 2-50 are eligible to enroll in the defined contribution system.
  2. How does the employer application process work?With the aid of a licensed broker, employers may register for the Utah Health Exchange via an online application. The Exchange then sends the application to two randomly selected participating carriers for approval. Once approved, the employer is notified and supplied with a unique website to which they direct their employees in order to complete health applications.
  3. What documentation must employers provide?Employers must provide a Census File and a Quarterly Wage & Tax file. New employers who have not yet filed a Quarterly Wage & Tax file may provide:
    • A copy of their business license along with a copy of their payroll
      OR
    • A copy of their Articles of Organization or Incorporation along with a copy of their payroll.
  4. Are there other employer responsibilities?Employers must establish a pre-tax mechanism for employees to use pre-tax dollars to purchase a health benefit plan through Avenue H. This may include:
    • A health reimbursement arrangement (HRA)
    • A Section 125 Cafeteria plan
      OR
    • Another plan or arrangement similar to mechanism 1 or 2 above which is excluded of deducted from gross income under the Internal Revenue Code

    The employer is also responsible for choosing a default health benefit plan for the group and for notifying each employee that he (the employee) will be enrolled in the default plan and payroll deductions will be initiated for premium payments unless:

    • The employee notifies the employer that he (the employee) has selected a different plan available through the Utah Health Exchange
    • The employee provides proof of other health benefit coverage
    • The employee specifically declines coverage in a health benefit plan

    Finally, the employer may not offer a major medical health benefit plan that is not part of the defined contribution arrangements available inside Avenue H.

MillerWade is authorized to quote business with Avenue H. For more information please contact us at 800.508.1144

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