The healthcare landscape is becoming more and more challenging to navigate, mainly due to increased scrutiny from the Department of Labor (DOL) and the IRS. With a rise in regulatory risks and litigation, employers are looking for healthcare plans that not only provide flexibility and meet their employees’ needs but also mitigate risk and decrease their chances of running into legal issues. Today’s terrain calls for a creative solution that addresses the legislative burdens employers face and the pain points of employees struggling to access affordable, quality healthcare. Our sister company, Ameriflex, has come up with a solution that provides just that: The Ameriflex Alternative Plan.
Legislative Burdens
The Consolidated Appropriations Act (CAA) impacts all employers offering group benefits, expanding on ERISA fiduciary duties for employers managing employee benefit contributions. The CAA now makes the employer a fiduciary of the health plan and requires the employer to provide pricing transparency and care navigation to employees. The CAA has also created two critical risk areas for employers: non-compliance fines and penalties from federal agencies and litigation from law firms. Large companies, such as Blue Cross Blue Shield and Mayo Clinic, have fallen prey to opportunistic lawyers seeking plaintiffs to file lawsuits against employers. Additionally, the Mental Health and Addiction Equity Act has also applied pressure on employers to provide mental health services that are equal to the health services provided. More than ever, plan compliance and risk mitigation have become top priorities for employers offering health plans to their employees.
The Solution: The Ameriflex Alternative Plan
The Ameriflex Alternative Plan (TAAP) is a solution that effectively addresses employers’ concerns surrounding compliance while fostering higher employee satisfaction. TAAP allows employers to build their own bundle to include cost-effective and quality employee options. With TAAP, employers have the option of bundling an Individual Coverage Health Reimbursement Arrangement (ICHRA), Telescope Health, and Intellect Mental Health together, creating a fair and affordable healthcare plan that combats the regulatory risks and rising health costs.
The ICHRA
The ICHRA, introduced in 2019 when Congress expanded HRAs, is a relatively new alternative to traditional group health insurance. This health benefit allows employers of any size to reimburse employees tax-free for some or all of their individual insurance premiums or other qualified medical expenses. The ICHRA alone offers undeniable benefits:
Affordability: The ICHRA eliminates the need for costly group health plans and stop-loss insurance.
Risk Mitigation: The ICHRA reduces liability by avoiding responsibility for group health plans, especially self-funded models.
Flexibility: ICHRAs allow employers to tailor their plans to meet company goals with 11 different classes and customizable reimbursement limits. The employer also has complete control over the reimbursement amount and can decide if the ICHRA will cover premiums only or premiums and 213(d) expenses.
Telescope Health
In partnership with Ameriflex and Accresa, Telescope Health is a leading provider of concierge virtual care. Telescope offers personalized concierge care navigation and virtual care services, ensuring employees have direct access to around-the-clock care. This partnership allows employees to receive immediate, high-quality care without feeling abandoned. At the same time, their existing health insurance remains as a backup for additional coverage.
Bundling Telescope Health with the ICHRA provides further compliance support for employers. It helps meet the care navigation requirements of the CAA and directly addresses employee pain points surrounding hidden costs, rising out-of-pocket costs, and confusing payment processes. With Telescope, employees have a 6-minute on-demand wait time average and access to 24/7 dedicated concierge care navigation, saving an average of $150 compared to going to urgent care.
Intellect Mental Health
Intellect Mental Health is a leading mental health tech company that offers manageable mental health support and behavioral guidance anytime and anywhere. Intellect’s mission is to redefine mental healthcare, to make mental health support more accessible, and to remove the stigma that surrounds seeking mental health support. Employees can access Intellect’s mental health app, which features guided journals, learning paths, rescue sessions, and self-guided programs that develop and support mental health.
Intellect helps employers meet the requirements of the Mental Health and Addiction Equity Act while also providing employees with needed mental health support, ultimately leading to higher employee satisfaction.
Additional TAAP Advantages
TAAP doesn’t stop at Telescope and Intellect; it offers additional support to employers. The partnership between Ameriflex and Accresa reduces the employer’s HR burden, allowing HR teams to focus on other priorities outside of managing the health insurance plan. Employers receive a comprehensive Fiduciary Guide, an in-depth overview of health plan duties complete with checklists, sample communications, and templates to help document complex compliance processes. All necessary ERISA compliance documents are also provided.
If employers are unsure about the complex plan design of the ICHRA and the intricate calculations it requires, they can use the Ameriflex Affordability Calculator. The calculator helps employers quickly decide if their plan design is affordable, calculates affordability based on key employee information, and indicates how much the employer should contribute to meet ICHRA affordability requirements.
Accresa’s Role
A significant pain point in the healthcare network is inefficient and inconsistent payment methods. At multiple points in the healthcare network, payment issues can occur; carriers can reject credit card payments for medical expenses, or employees may forget to make payments, leading to coverage lapses. Accresa is partnering with Ameriflex to manage eligibility and payment to third-party providers.
Virtual payments also simplify benefits administration by automating premium payments via ACH transfers, reducing the burden on employers and minimizing errors. This approach eliminates the need to monitor individual payments and the need for physical checks and cash transactions, avoids extra credit card fees, and ensures reliable compliance with ICHRA guidelines.
The Ameriflex Alternative Plan might be the solution you’ve been looking for. Want to learn more? Contact Ameriflex today.
