{"id":1292,"date":"2017-02-02T15:37:36","date_gmt":"2017-02-02T15:37:36","guid":{"rendered":"http:\/\/hnetalk.com\/employer\/?p=1292"},"modified":"2017-11-14T20:03:22","modified_gmt":"2017-11-14T20:03:22","slug":"counting-employees-full-time-equivalent","status":"publish","type":"post","link":"http:\/\/hnetalk.com\/employer\/2017\/02\/02\/counting-employees-full-time-equivalent\/","title":{"rendered":"Counting Employees: Full-Time Equivalent"},"content":{"rendered":"

For market segment determination, employers must count their Full-Time Equivalent (FTE) employees as of the effective date of their new coverage. The count is not based on a rolling 12-month average. Employers are encouraged to contact their assigned sales representative directly to provide the required information.<\/p>\n

Effective August 10, 2016, the Commonwealth of Massachusetts issued Bulletin 2016-09 regarding \u2018Determining whether an Employer is Eligible for Small Employer Coverage.\u2019 This bulletin outlines the new method for determining market segment based on the number of Full-Time Equivalent (FTE) employees. FTEs include all of the employer\u2019s staff \u2013 including full-time, part-time and temporary staff. As in the past, business owners and those holding more than 2% of stock ownership are not considered employees.<\/p>\n

Brokers and employers are to use the federal SHOP calculator at https:\/\/www.healthcare.gov\/shop-calculators-fte\/#<\/a> to calculate the FTE count.<\/p>\n

MASSACHUSETTS PRIOR AND NEW CALCULATIONS FOR MARKET SEGMENT<\/strong><\/p>\n\n\n\n\n\n
Market Segment<\/th>\nCalculation Prior to Bulletin 2016-09<\/th>\nNew DOI Calculation<\/th>\n<\/tr>\n
Small Group<\/td>\n50 or fewer Eligible<\/td>\n50 or fewer Full-Time Equivalents<\/td>\n<\/tr>\n
Large Group<\/td>\n> 50 Eligible<\/td>\n> 50 Full-Time Equivalents<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

What this means to employers:<\/strong><\/em> Prior to the date of the bulletin, an employer was part of the small group segment if it had 1-50 eligible employees. Now, an employer that has 1-50 full-time equivalents, regardless of where the employees are located, is part of the small group market.<\/p>\n

Example:<\/strong>
\nBefore:<\/strong> An employer had 60 employees; 10 were eligible and enrolled in the plan. This was a small group employer.
\nNow:<\/strong> The same employer has 60 employees. Using the SHOP calculator (which takes into account all full-time, part-time and temporary employees), the employer is determined to have 52 FTEs; however, there are still only 10 who are eligible and enrolled. This employer is now part of the large group market and will be rated using the community rated class (CRC) method because it has fewer than 100 enrolled.<\/p>\n

Employers will begin receiving a Data Verification request from their Health New England Sales Representative. This request will be sent by email to the Group\u2019s main contact a few months prior to the plan renewal and will include a request for an FTE count. Timely response to this email will be required to ensure that your Group is rated in the appropriate market segment and renewal information is delivered in a timely fashion. A response will be required 60 days prior to your renewal<\/strong>.<\/p>\n

What this means for brokers:<\/strong> <\/em>Health New England will continue to rely on our brokers to assist their groups in providing timely and accurate responses to the Data Verification request.<\/p>\n

How this affects employers and members:<\/strong><\/em> If a group that was formerly in the small group market moves to the large group market due to the new calculation method, there will be some changes in benefits. The group will also be required to provide and file Form 1095-C to its employees and the IRS.<\/p>\n

Small Group benefits\u00a0not available\u00a0<\/u>to Large Groups:<\/strong><\/p>\n

    \n
  • Comprehensive dental benefit for dependents under age 19 (Note<\/strong>: Health New England no longer offers the preventive pediatric dental benefit to large groups.)<\/li>\n
  • Acupuncture and massage<\/li>\n
  • Comprehensive pediatric vision coverage (new to small group in 2017)<\/li>\n<\/ul>\n

     <\/p>\n

    Important:<\/strong> Benefit changes must be communicated by the Broker and\/or Employer Group to the Member prior to the start of the new plan year for groups that are changing market segments due to the new calculation methodology.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

    For market segment determination, employers must count their Full-Time Equivalent (FTE) employees as of the effective date of their new coverage. The count is not based on a rolling 12-month average. Employers are encouraged to contact their assigned sales representative directly to provide the required information. Effective August 10, 2016, the Commonwealth of Massachusetts issued […]<\/p>\n","protected":false},"author":8,"featured_media":1293,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[3],"tags":[],"class_list":["post-1292","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-emails"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"http:\/\/hnetalk.com\/employer\/wp-content\/uploads\/2017\/02\/ThinkstockPhotos-469539087-e1486049820425.jpg","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p6ZZu3-kQ","_links":{"self":[{"href":"http:\/\/hnetalk.com\/employer\/wp-json\/wp\/v2\/posts\/1292","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/hnetalk.com\/employer\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/hnetalk.com\/employer\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/hnetalk.com\/employer\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"http:\/\/hnetalk.com\/employer\/wp-json\/wp\/v2\/comments?post=1292"}],"version-history":[{"count":6,"href":"http:\/\/hnetalk.com\/employer\/wp-json\/wp\/v2\/posts\/1292\/revisions"}],"predecessor-version":[{"id":1434,"href":"http:\/\/hnetalk.com\/employer\/wp-json\/wp\/v2\/posts\/1292\/revisions\/1434"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/hnetalk.com\/employer\/wp-json\/wp\/v2\/media\/1293"}],"wp:attachment":[{"href":"http:\/\/hnetalk.com\/employer\/wp-json\/wp\/v2\/media?parent=1292"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/hnetalk.com\/employer\/wp-json\/wp\/v2\/categories?post=1292"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/hnetalk.com\/employer\/wp-json\/wp\/v2\/tags?post=1292"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}