Employer insists plan meets Minimum Value Standard (it doesn’t) and refuses to fill out Employer Coverage Tool to ensure I can get ACA premium tax subsidies. What can I do? What if they lie to the government and claim they offered a compliant plan and we get back-charged for subsidies?
My wife is working a contract position at a temp agency. The temp agency offers a health care plan that seems to be an indemnity plan or something – there’s no deductible or out of pocket max. Here’s a screenshot of it. I was assured in a prior post to this subreddit that this plan does not meet the Minimum Value standard. As such, we intend to fill out an ACA application and get premium tax subsidies.
When I asked the employer to fill out the Employer Coverage Tool to verify that they indeed don’t offer an ACA-compliant plan (and that therefore I am entitled to ACA premium subsidies), they refused.
I’m aware that I can still fill out the ACA application and claim the employer does not offer adequate coverage. However, my understanding is that the employer will be fined by the government for not offering an adequate plan unless they can prove they offered one.
I’m worried that they’ll lie to the government and claim they offered us an adequate plan and the government will take their word for it. What can we do to guard ourselves against this? How can we fight back if the government back-charges us for a year of premium subsidies?
And what can we show the employer that might get them to understand that the plan they’re offering does not meet the Minimum Value Standard? I think they might be mistaking Minimum Essential Coverage with Minimum Value. I’ve tried linking them to healthcare.gov’s minimum value glossary entry, but I’d like something more concrete. I want to be able to link to an exact sentence and say: “See? THIS here is what your plan does not offer.” A vague line about “at least 60% of the total cost” and “substantial coverage of physician and inpatient hospital services” may just not cut it.
(Please don’t merely advise quitting. Obviously we don’t like this employer and obviously we’d quit if we could. You don’t need to know the details of our circumstances to simply trust me that this isn’t realistic.)
Thanks!