ABOUT NATIONAL HEALTH
SUPPORT / FAQ
ANSWERS TO YOUR QUESTIONS
SUPPORT
Thank you for your interest in National Health Benefits. Please review the below Frequently Asked Questions if you find yourself needing additional support. If you cannot find an answer to your question below, please feel free to contact our office at 1 (800) 407-5772.
LARGE BUSINESS EMPLOYERS (ALE’s)
50 OR MORE FULL TIME EMPLOYEES
No, all benefit plans available from National Health Benefits (and in conjunction with HealthShare Connection) will be offered on each employee’s election form. The Affordable Care Act requires that an employer must provide Minimum Essential Coverage (our Basic Plan) and offers a Minimum Value Plan (our MVP Plan) for all eligible employees. We naturally include both of these options on our election forms. However, our most popular plans are our Mega Plan and the HealthShare Connection+ Mega Plan. These plans give employees the lowest cost healthcare options with much better overall coverage and care.
An employee who works an average of 30 or more hours per week is considered full-time and therefore entitled to compliant healthcare options made available by their 60th day of employment. If at any time an employee reaches 120 worked hours per month, they must be added to the National Health Benefits employee census. An employee may be removed from the census once they have worked less than 120 hours per month for 3 consecutive months.
The ERISA Act requires that healthcare plans provided for Minimum Essential Coverage must be “Employer-Sponsored”. For National Health Benefits, this means that employers will be required to contribute no less than 50% of the Basic Plan at $30 per month, per employee. If an employer wishes to contribute more than the $30 per employee, per month, this will be at the company’s discretion. Once per month, the employer will combine their healthcare contribution with the employee’s contribution (by way of payroll deduction) to pay National Health’s fees in total. Fees are due by the 10th of each month.
National Health requires a monthly maintenance fee for any eligible employee working 30 or more hours per week who has waived their offer of coverage from National Health Benefits. This fee amounts to $15 per month, per waived employee. The Maintenance Fee covers plan administration costs, which include: the cost of the notification (printing, mailing, call center) of the offer of the Medical Plan, and MVP plans themselves; the offer documentation; the contingent ERISA Employer Self-Funded Health Plan Summary of Coverage documents; and all of the ACA, IRS, and ERISA documentation (INC Code 6056 forms 1094’s, 1095’s); Form 5500 Section 4980H (a) (b); PCORI annual fee filing fee; Cobra Notices; Fair Labor Standards Act-FLSA; TPA Fees; Forms Preparation and Filing Fees; Annual Reports Filing Fees. These functions apply to all employees and not just the Medical Plan enrolled employees. All employees must have an offer notification, and the enrollment documents have to be made available for each employee should an IRS request be made. Additionally, the employer is protected from the penalties on each employee by this documentation on a month to month bases. National Health responds to every request from the various regulators (IRS, DOL), files all dispute and appeal paperwork, and assists the employer in every way to make sure their compliance is complete.
Absolutely! Our healthcare plans can be offered to both full-time and part-time employees at the discretion of the employer. Please be aware that once a benefit plan is elected during Open Enrollment, that plan must be maintained as active until the following Open Enrollment occurs during the next calendar year. The only opportunity for an employee to downgrade or change their coverage with National Health Benefits during the calendar year would be after a qualifying event such as birth, death or divorce in the family, or if an employee becomes terminated from the company.
National Health sends out monthly invoices on the first of every month. Payments are processed by ACH withdrawal on the 10th of the month. Employers should review their online invoice and contact National Health with any changes by the fifth of the month to avoid any errors in the billing process.
If you have decided to choose another healthcare partner to take over your benefit needs, National Health Benefits requires a 30 day written notice with explanation for termination of services. Please send any cancellation notices to Admin@NationalHealthBenefits.org.
STANDARD BUSINESS EMPLOYERS
11-49 EMPLOYEES, LESS THAN 6000 HOURS WORKED PER MONTH
No, all benefit plans available from National Health Benefits (and in conjunction with HealthShare Connection) will be offered on each employee’s election form. These plans are set up to offer a wide coverage and price range for employees that may have different healthcare needs within the same company. The main choice an employer needs to consider on an employee’s election form, is the amount of contribution towards the different benefit plans.
As an employer of 49 or fewer full-time employees, the Affordable Care Act regulation does not apply to Small Businesses in the same way that it applies to Applicable Large Employers (ALE). National Health programs are, however, bound by the laws of the ERISA Act. This legislation requires that self-funded benefits are “employer sponsored”. We’ve set a minimal Employer Contribution at $30 per employee, per month, however an employer is free to increase that amount at their discretion.
As an employer of 49 or fewer full-time employees, offering healthcare coverage is not mandated by the Affordable Care Act at this time. However, the ERISA Law governs the self-funded benefits that are offered through National Health Benefits. The ERISA Act proposes that a plan be employer-sponsored thus a contribution from the employer on behalf of the employee has been set at $30 per active employee, per month at National Health Benefits. Additionally, if healthcare benefits are offered to any one employee of the company, they must be offered to all eligible employees at the time they become eligible for healthcare coverage (by their 90th day of employment). If the company grows in size to exceed 50 full-time employees or the equivalent there-of (6000 monthly hours), guidelines from the ACA will then apply.
Absolutely! Our healthcare plans can be offered to both full-time and part-time employees at the discretion of the employer. Please be aware that once a benefit plan is elected during Open Enrollment, that plan must be maintained as active until the following Open Enrollment occurs during the next calendar year. The only opportunity for an employee to downgrade or change their coverage with National Health Benefits during the calendar year would be after a qualifying event such as birth, death or divorce in the family, or if an employee becomes terminated from the company.
National Health sends out monthly invoices on the first of every month. Payments are processed by ACH withdrawal on the 10th of the month. Employers should review their online invoice and contact National Health with any changes by the fifth of the month to avoid any errors in the billing process.
If you have decided to choose another healthcare partner to take over your benefit needs, National Health Benefits requires a 30 day written notice with explanation for termination of services. Please send any cancellation notices to Admin@NationalHealthBenefits.org.
SMALL BUSINESS EMPLOYERS
1-11 EMPLOYEES
Our online enrollment process is easier than ever to navigate. Simply visit the National Health Benefits homepage and click on the “Enroll Now” button. Please enter your contact and tax information as requested on the first page, and click continue to proceed to the election process. Please note, if you currently file your taxes under an EIN number, please provide this number so that we can appropriately issue your relevant healthcare tax forms at the end of the year. On the second page of enrollment, please enter the Company Code: INDIVIDUAL to generate the pricing options (as described in this proposal document. Then, continue to select the healthcare options that are best suited for yourself and your family. The third page of enrollment allows you to set up your online auto-draft for monthly payment. At this time, only ACH bank authorized transactions are available for payment options. No credit card payments are permitted.
When setting up your online account, you will need your contact information, your social security number, your business EIN number (if applicable), your banking information and your Company Code. If you have not been given a Company Code by a broker or National Health sales representative, please use the code INDIVIDUAL.
The National Health Benefit plans are created using the ERISA Act of 1974 which allows employers to self-fund their benefit programs. As an individual contractor or small business owner, you act as the employer who is self-funding these programs. National Health acts as an Third Party Administrator who handles your claims processing and compliance. Thus, this program is only available to individuals who are their own employer, small companies who use a DBA with limited employees, and small to large businesses.
If you or your mini company is electing coverage in the middle of the calendar year, your open enrollment begins from the time you decide to elect coverage through National Health Benefits to the time you officially make your benefit plan selections. National Health also conducts an annual member-wide Open Enrollment from October 15- December 15 of ever year. In September, National Health will notify you of any new plan options or changes. If National Health isn’t contacted with changes, your account will auto-renew.
Coverage on your newly enrolled plan begins the 1st of the month following your Open Enrollment period. If you sign up for National Health Benefits plan during the first 5 days of the month and would like to being coverage during that same month, please contact National Health to approve the early enrollment.
Once you begin coverage with a benefit plan at National Health, you must stay enrolled in the program for at least 12 calendar months following your 1st day of coverage. In order to cancel your coverage following your year-long introductory period, National Health must receive written notice of your intent to cancel 30 days before your next billing cycle as well as reason for cancellation.
INDIVIDUAL
All employees that work a minimum of 30 hours per week and/or considered full time employees, as defined under the Affordable Care Act, are eligible to enroll. Eligible dependents include spouses and children or stepchildren, under the age of 26. Part Time employees can enroll in either Program at their employer’s discretion, but he/she may be responsible for the full cost of the program. Please check with your employer regarding their contribution.
Either the Basic Plan or Mega Plan/Mega Plus HSC programs can be added at any time. The Minimum Value Plan (MVP) can only be added during the open enrollment period or during the waiting period, if newly hired. If you do not elect coverage during the open enrollment period, you will not be able to enroll for the MVP plan until the next open enrollment period unless you experience a qualifying event.
If you are electing coverage in the middle of the calendar year, your open enrollment begins from the time you decide to elect coverage through National Health Benefits to the time you officially make your benefit plan selections. National Health also conducts an annual member-wide Open Enrollment from October 15- December 15 of ever year. In September, National Health will notify you of any new plan options or changes. If National Health isn’t contacted with changes, your account will auto-renew.
Once you begin coverage with a benefit plan at National Health, you must stay enrolled in the program for at least 12 calendar months following your 1st day of coverage. Premiums are paid with pre-tax dollars through payroll deductions. You will not be able to change these elections for the Basic, Mega or Mega+ HSC Plans until the next annual enrollment period, unless you have a qualifying event. In order to cancel your coverage following your year-long introductory period, National Health must receive written notice of your intent to cancel 30 days before your next billing cycle as well as reason for cancellation.
Fees will be taken through payroll deductions. If you miss a payroll deduction as a result of absence, lack of work, or termination, you risk being cancelled from the (MED or MVP) plans. If the plan is cancelled, you will not be eligible to re-enroll in the MVP plan until the next open enrollment period unless you experience a qualifying event. However, the Basic Plan or Mega Plan programs can be reinstated once the back premiums are made current.
We are proud to offer our employees 3 easy ways to elect for coverage in a new National Health Benefits plan.
PAPER: You will be provided an Open Enrollment Packet during your Open Enrollment Period. Attached to this document will be a paper Election Form, Family & Dependent Form and HealthShare Connection Application. Please fill this out and return it to your company representative, or email it to admin@NationalHealthBenefits.org.
ONLINE: Please find the National Health website at www.NationalHealthBenefits.org and click on “National Health Login” at the top of the page. Then, click on “Employee Login” and enter the Employer ID provided in your Open Enrollment Packet. Please note: the program will prompt you to enter additional personal information to access your account.
PHONE: If you would prefer to call to make your health benefit selections, please call the National Health Benefits office at (800) 407-5772 where both English and Spanish speaking representatives are standing by to answer your call.