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New Rate Table Request

More and more employers in small group are paying 100% of the "Employee Only" portion of the premium and 0% (or whatever) towards the Dependent portion of the premium rates. These premiums are typically age banded and can be different for almost every age and every coverage type. 

The existing rate table structure does not allow for 100% employer paid EE only coveage with 0% towards dependent costs. The amounts for employee deductions would always be wrong depending on your age.

Our suggestion would be to create a new rate table using the following:

1) Ee

2) Add'l Cost to Add Spouse

3) Add'l Cost to Add Child(ren)

4) Add'l Cost to Add Family 

instead of:

1) Employee

2) Employee & Spouse

3) Employee & Child(ren)

4) Family

Using the new table, the employer can accurately provide the premiums pre paycheck based on their actual contributions strategy. It would be necessary to add the rates together to get the total premium to calculate the benefit statement information. 

To do this work around requires use to currently use an Excel spreedsheeet to create the rates based on the employer contributions and then we force the employer/ee contributions to be 100% when it actually may be something else. As a result, the benefits statements do not reflect the full premium paid by the employee and or their dependents.

1 person likes this idea

I agree with what you are saying. I am very new to this service but I set-up a medical plan with a full table age band and there was an option for contribution and that was broken out into employee, spouse, child, spouse and children. I think that would solve your problem.

I have a new twist that maybe someone can help me with...

I have a client with 2 plans. He pays 50% of the lower cost plan for employees only and then the higher cost plan he charges them the 50% of the low cost plan and the difference in cost of the low to high plan. The only thing I can think of is to see if there is a consistent percentage difference in the plans but It will be off I am sure given a different rate for every age.

i would like to see a feature that allows for contributions to be calculated based on the price different of a base plan. I do have employers with 3 plans and with some carriers now allowing the choice of 42 plans... it is going to be more important to have the feature I describe.

My only hope is that Congress gets their act together and gets rid of age banded ratting on group plans. It is an administrative nightmare!


I agree with your comment. Since October of last year we are finding that employers are selecting a base plan (usually the lowest cost plan) and allowing the employees to buy-up to any plan they want to pay for.  The program will need to be able to calculate this formula to be useful. Otherwise, it's a time-consuming hand calculation that takes too much time and takes away from the self service feature.

The coding would be simple. You would set up several tables of rates by ages and then simply subtract the employers contribution. This would always give you the employee's portion of the costs for the employee and the dependents.

We are seeing this issue more frequently and our programmers are currently working on a solution.  We hope to have something in the next 3 weeks.

Just checking into whats going on with this feature. It has been 3 months and nothing has been done or talked about.

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