Understanding Minimum Essential Coverage (MEC) can be complicated when compared to minimum value, essential health benefits, and actuarial value. 

Let’s start by answering: what is it and what does it cover? Minimum Essential Coverage is a plan that meets the Affordable Care Act (ACA) requirements for health coverage. Some of these programs include:

  • Marketplace plans
  • Job-based plans
  • Medicare
  • Medicaid

All applicable large employers (ALEs) with 50 or more full-time or full-time equivalent employees are required by law to provide ACA-compliant health coverage to their employees. ALEs who do not provide coverage ACA-compliant coverage are subject to fines and penalties from the Internal Revenue Service. 

What Are the Minimum Essential Coverage Option Levels Available?

There are three different plan options available. Understanding the difference between the three helps employers decide which MEC plan is best for their employees.

  • Standard MEC plans are ACA compliant and include coverage for wellness, preventative services, prescription discounts, and telehealth services. 
  • Enhanced MEC plans take coverage one step further than standard plans and are aimed at attracting and retaining top talent by also including primary and urgent care visits with low copays, and discounted specialist and laboratory services. 
  • The highest-level MEC plans include the enhanced MEC plan benefits along with added coverage such as prescription coverage and low copays. 

What Do Minimum Essential Coverage Plans with Hospital Indemnity Cover?

The goal of worksite MEC plans is to provide affordable healthcare coverage for the average person. MEC plans with added hospital indemnity policies can offset high deductibles and full out-of-pocket expenses so that an emergency does not become a financial crisis. The 10 health benefits they include are:

  1. Ambulatory Patient Services (outpatient services)
  2. Emergency Services 
  3. Hospital Visits 
  4. Maternity and Newborn Care
  5. Pediatric Services (including oral and vision)
  6. Mental Health and Substance Use Disorder Services (including behavioral health treatment) 
  7. Prescription Drugs
  8. Rehabilitative and Habilitative Services and Devices 
  9. Laboratory Services 
  10. Preventative and Wellness Services and Chronic Disease Management 

How Much Do You Save With MEC?

ALEs who fail to provide 95% of their full-time employees with ACA-compliant benefits are subject to high fines and penalties. Use our calculator to find out how much your business can save by providing Minimum Essential Coverage benefits while staying compliant with federal regulations.

Use our MEC Benefits calculator to see how much your business can save by offering MEC coverage.

What is the Difference Between MEC and Minimum Value?

Minimum value is a higher threshold than MEC. Minimum value is when a plan pays 60% of the actuarial value of allowed benefits under the plan. If a large employer offers benefits and meets Minimum Essential Coverage requirements, but they do not meet the minimum value, they meet the ACA employer requirements.

MEC and Essential Health Benefits

Essential health benefits are the core benefits that “qualified health plans” must cover. MEC also has a lower threshold than essential health benefits. If a group health plan doesn’t provide all of the benefits under essential health benefits, the coverage will likely meet Minimum Essential Coverage, so companies will be ACA-compliant.

Why is it Important to Understand the Differences?

Each of these coverage specifications is important to ensure large employers provide proper coverage to their employees. As an employer, you must understand your legal liability in providing benefits, as well as understanding what coverage you need to offer your employees to give them the best options and ensure compliance with the ACA. 

Curious why offering health insurance to your employees is so important? It encourages and promotes a healthier, happier, and stronger workforce. Read our article that explains why healthy employees improve work productivity here.

Healthcare insurance brokers are constantly looking for ways to provide the best for their clients while increasing their margins. If this is the case for you, look no further!

Innovative HIA provides the most competitive rates for Minor Medical coverage plans. Our mission as a benefits administrator is to help you—as a healthcare insurance provider—deliver the best for your clients (and a little extra commission wouldn’t hurt).

Below are a few tips on how to increase margins as a healthcare insurance broker (Hint: we saved the best tip for last!)

How to Increase Your Margins as a Healthcare Insurance Broker

As a healthcare insurance broker, you are always looking for ways to provide the best possible coverage for your clients while also increasing your own margins. 

There are a few key ways that you can do this:

Get Higher Commissions

One way to increase your margins is to simply get higher commissions from the insurance carriers you work with. This can be done by negotiating better terms with the carriers, or by simply switching to carriers that offer higher commissions. (But more on this later!)

Get Better Insurance Rates

Another way to increase your margins is to get better insurance rates for your clients. This can be done by:

  • Hopping around for the best rates
  • Using discounts, or
  • Simply being aware of the different rates that are available

Increase Your Efficiency

Finally, you can also increase your margins by increasing your efficiency as a healthcare insurance broker. This means finding ways to work faster and more efficiently, saving you time and money long-term.

How Brokers Can Earn Higher Commissions with Innovative HIA

We told you we saved the best tip for last! Working with Innovative HIA is the easiest way you can increase your margins as a healthcare insurance broker.

At Innovative HIA, our ACA-compliant policies start at a base price with a set commission built-in. Additionally, we work with our brokers to ensure you feel comfortable with the commission you’re earning – no one knows how much your time is worth except for you and we want you to be satisfied with your rate.

Brokers that work with Innovative HIA can set their insurance rates to reflect the market and effort they put into managing their accounts. 

Increase Your Margins by Working with Innovative HIA!

By following these tips as a healthcare insurance broker, you can easily increase your margins. This will allow you to provide even better coverage for your clients while also making more money yourself. So don’t wait, start increasing your margins today!

Get in touch with Innovative HIA today to learn more or read on to learn how brokers can get their employer groups engaged!

At Innovative HIA, we pride ourselves on offering:

  • Affordable Benefits
  • ACA Compliance, and
  • Exceptional Service

Today, we’d like to chat a bit more about the third element—the exceptional service we provide—and why Innovative HIA is, therefore, the gold standard of customer service for Minor Medical insurance providers.

(Hint: Our one-stop-shop benefits portal plays a large role in our successful customer service efforts!)

Let’s dive in.

How Innovative HIA Supports the Onboarding and Offboarding Processes

At Innovative HIA, we support businesses beyond providing Minor Medical coverage. We are proud to support the employee onboarding process so your human resources (HR) teams have more time to focus on the daily tasks that keep your business running.

This is why we offer a complete insurance solution that covers:

  • Implementation
  • Enrollment
  • Administration, and
  • Reporting

Our benefits professionals are fully equipped to support onboarding and offboarding procedures to eliminate the hassle for businesses.

How? Using our benefits portal.

Our Benefits Portal

Employee benefits administration can be a pain for any HR department. At Innovative HIA, we aim to simplify the process by giving you access to everything you need in one place.

Our one-stop-shop portal is proprietary and unlike any other. Our portal grants you access to all of the tools necessary to support a new hire (from beginning to end).

We eliminate the headache of unnecessary paperwork with benefits management portal access. You can:

  • Make plan changes
  • Order ID cards
  • Check claim status online
  • Track onboarding and offboarding
  • And more

Resources are only a click away.

Besides creating a seamless onboarding process with our all-in-one portal, we also provide video tutorials for our partners. These resources provide instructions that assist navigation through the portal.

Read on to view our enrollment portal walkthrough.

Minimum essential coverage is health insurance that meets the Affordable Care Act requirements. Employers have a requirement to offer at least Minimum Essential Coverage to any benefit-eligible employee. Non-compliance can result in a penalty of $214.17 PER eligible employee per month without coverage.

At Innovative HIA, we aim to offer affordable, flexible, and compliant coverage for all employers.

What Does Minor Medical Cover?

Our Minor  Medical plans cover 100% of preventive services and wellness visits to the doctor. In addition, all members have access to 24/7/365 telehealth services and discounts on generic and brand prescriptions. 

These plans are the most affordable option under Minimum Essential Coverage. 

What Does Major Medical Cover?

Major Medical covers the preventative services and wellness visits mentioned above, as well as primary care and specialist visits with a $15 copay. As well as urgent care, labs, and X-rays with a $50 copay. 

24/7/365 telehealth services are included under this plan, along with access to behavioral health telehealth services

Prescriptions under the Major Medical plan are covered based on your coverage tier.

*$50 fee max 3 per year

Preventative Services Covered Under Minor Medical

Both plans cover preventative services and wellness visits. The services covered depend on age and gender. Here’s a look at the coverage offered under preventative services:

Covered Preventative Services for Adults

  • Abdominal aortic aneurysm one-time screening for men of specified ages who have ever smoked
  • Alcohol misuse screening and counseling
  • Aspirin used to prevent cardiovascular disease in men and women of certain ages
  • Blood pressure screening for all adults
  • Cholesterol screening for adults of certain ages or at higher risk
  • Colorectal cancer screening for adults over 50
  • Depression screening for adults
  • Diabetes (Type 2) screening for adults with high blood pressure
  • Diet counseling for adults at higher risk for chronic disease
  • Falls prevention (with exercise or physical therapy and vitamin D use) for adults 65 years and over
  • Hepatitis B screening for people at higher risk
  • Hepatitis C screening for adults at increased risk, and one time for everyone born 1945 –1965
  • HIV screening for everyone ages 15 to 65, and other ages at increased risk
  • Immunization vaccines for adults — doses, recommended ages, and recommended populations vary: Hepatitis A, Hepatitis B, Herpes Zoster, Human Papillomavirus, Influenza (flu shot), Measles, Mumps, Rubella, Meningococcal, Pneumococcal, Tetanus, Diphtheria, Pertussis and Varicella
  • Lung cancer screening for adults 55 – 80 at high risk for lung cancer because they’re heavy smokers or have quit in the past 15 years
  • Obesity screening and counseling for all adults
  • Sexually Transmitted Infection (STI) prevention counseling for adults at higher risk
  • Statin preventive medication for adults 40 to 75 years at higher risk
  • Syphilis screening for all adults at higher risk
  • Tobacco use screening for all adults and cessation interventions for tobacco users
  • Tuberculosis screening for certain adults with symptoms at higher risk

Covered Preventative Services for Women

  • Anemia screening on a routine basis for pregnant women
  • Breast Cancer Genetic Test Counseling (BRCA) for women at higher risk for breast cancer (counseling only; not testing)
  • Breast cancer mammography screenings every 1 to 2 years for women over 40
  • Breast cancer chemoprevention counseling for women at higher risk
  • Breastfeeding comprehensive support and counseling from trained providers, and access to breastfeeding supplies, for pregnant and nursing women
  • Cervical cancer screening
  • Chlamydia Infection screening for younger women and other women at higher risk
  • Contraception: Food and Drug Administration-approved contraceptive methods, sterilization procedures, and patient education and counseling, as prescribed by a health care provider for women with reproductive capacity (not including abortifacient drugs). This does not apply to health plans sponsored by certain exempt “religious employers.”
  • Diabetes screening for women with a history of gestational diabetes who aren’t currently pregnant and who haven’t been diagnosed with type 2 diabetes before
  • Domestic and interpersonal violence screening and counseling for all women
  • Folic acid supplements for women who may become pregnant
  • Gestational diabetes screening for women 24 to 28 weeks pregnant and those at high risk of developing gestational diabetes
  • Gonorrhea screening for all women at higher risk
  • Hepatitis B screening for pregnant women at their first prenatal visit
  • HIV screening and counseling for sexually active women
  • Human Papillomavirus (HPV) DNA Test every 5 years for women with normal cytology results who are 30 or older
  • Osteoporosis screening for women over age 60 depending on risk factors
  • Preeclampsia prevention and screening for pregnant women and follow-up testing for women at higher risk
  • Rh Incompatibility screening for all pregnant women and follow-up testing for women at higher risk
  • Sexually transmitted infections counseling for sexually active women
  • Syphilis screening for all pregnant women or other women at increased risk
  • Tobacco use screening and interventions for all women, and expanded counseling for pregnant tobacco users
  • Urinary tract or other infection screening, including urinary incontinence
  • Well-woman visits to get recommended services for women under 65

Covered Preventative Services for Children

  • Alcohol and drug use assessments for adolescents
  • Autism screening for children at 18 and 24 months
  • Behavioral assessments for children at the following ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years.
  • Bilirubin concentration screening for newborns
  • Blood pressure screening for children at the following ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years
  • Blood screening for newborns
  • Cervical dysplasia screening for sexually active females
  • Depression screening for adolescents
  • Developmental screening for children under age 3
  • Dyslipidemia screening for children at higher risk of lipid disorders at the following ages: 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years.
  • Fluoride chemoprevention supplements for children without fluoride in their water source
  • Fluoride varnish for all infants and children as soon as teeth are present
  • Gonorrhea preventive medication for the eyes of all newborns
  • Hearing screening for all newborns, and for children once between 11 and 14 years, once between 15 and 17 years, and once between 18 and 21 years
  • Height, weight, and Body Mass Index measurements for children at the following ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years.
  • Hematocrit or hemoglobin screening for all children
  • Hemoglobinopathies or sickle cell screening for newborns
  • Hepatitis B screening for adolescents ages 11 to 17 years at high risk
  • HIV screening for adolescents at higher risk
  • Hypothyroidism screening for newborns
  • Immunization vaccines for children from birth to age 18 — doses, recommended ages and recommended populations vary: Diphtheria, Tetanus, Pertussis, Haemophilus influenza type B, Hepatitis A, Hepatitis B, Human Papillomavirus, Inactivated Poliovirus, Influenza (Flu Shot), Measles, Meningococcal, Pneumococcal, Rotavirus and Varicella
  • Iron supplements for children ages 6 to 12 months at risk for anemia
  • Lead screening for children at risk of exposure
  • Maternal depression screening for mothers of infants at 1, 2, 4, and 6-month visits
  • Medical history for all children throughout development at the following ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years.
  • Obesity screening and counseling
  • Oral Health risk assessment for young children Ages: 0 to 11 months, 1 to 4 years, 5 to 10 years.
  • Phenylketonuria (PKU) screening for this genetic disorder in newborns
  • Sexually transmitted infection (STI) prevention counseling and screening for adolescents at higher risk
  • Tuberculin testing for children at higher risk of tuberculosis at the following ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years.
  • Vision screening for all children.


Read on for more information on minor medical insurance plans and what they cover.

Navigating the similarities and differences between individual and voluntary benefits can seem challenging. Which ones do your employees want? What can employees get from individual benefits that they can’t from voluntary? How can benefits attract and retain great talent?


Here is a list of the major similarities and differences between the two to help you navigate what benefits you want to provide.


  • Customizable options: Both benefit options have multiple coverage options available. These customizations give people the ability to change their options to cater to their needs, their family size, and their budget.
  • Dependent coverage: You have the ability to add eligible dependents, like your spouse and children, for an additional charge.
  • There are various areas that are covered: Both types of insurance cover dental, vision, disability, and life insurance.


  • Voluntary benefits are sponsored by your employer: Voluntary benefits are only offered through employer-sponsored healthcare plans. Those who are not employed do not have access to voluntary benefit options. The employer also chooses what options are offered and what the coverage levels are. As an employer, this can be a great way to differentiate your company.
  • Individual insurance is completely paid for by an employee: Some business owners pass the cost of voluntary benefits on to their employees, though it is not required. Some employers will also cover a portion of voluntary benefit elections for their employees. With individual coverage, the employees take the entire cost.

At Innovative HIA, we understand how important your employees are to your organization. Offer your employees the most options for coverage. When you offer your employees more options when it comes to benefits, they will likely have higher engagement levels as they feel you care for their wellbeing. Contact us to learn more about the voluntary benefits you can offer your employees.


Read on to learn more about how you can add value to your existing benefits plans. 


Article originally published on SBMA Benefits.

infographic on how to navigate individual and voluntary benefits

The Affordable Care Act (ACA) implemented an individual mandate, also known as the “individual shared responsibility provision” that requires that most Americans have qualifying insurance.


Read more about what Minor Medical is and what it covers here.


Until 2018, those who did not prove themselves to have health insurance when filing taxes were penalized. The Tax Cuts and Jobs Act of 2017 eliminated that requirement. Now, however, the financial penalty is repealed, but Americans are still required to have health insurance. 


In order to stabilize the healthcare marketplaces, some states took it upon themselves to create state-wide individual mandates. This helps balance the marketplace because when healthy individuals have health insurance, it spreads the cost of care so those with chronic conditions do not end up paying as much. 


States with Individual Mandates 

Not all 50 states have individual mandates. 


Only the following states participate:


  • California 
  • The District of Columbia 
  • Massachusetts
  • New Jersey 
  • Vermont 
  • Rhode Island 


There are benefits and drawbacks to state individual mandates. According to the ACA Times, “These states’ individual mandates have resulted in greater healthcare participation but have also created challenges for employers and their ACA compliance efforts.”


For example, in 2022, a record number of people (over 15 million people) enrolled in health insurance coverage. 

States Considering Implementing Individual Mandates 

The states mentioned above with individual mandates may increase in number.  A handful more states are considering implementing their own state-wide individual mandates. 


Those states include:


  • Hawaii
  • Connecticut
  • Minnesota
  • Washington
  • Maryland 


Are There Financial Penalties in States with Individual Mandates?

In short, yes. The states with individual mandates do impose financial penalties to those without health insurance despite the Tax Cuts and Jobs Act of 2017. 



California residents are required to have health insurance or provide an exemption to health insurance. In 2021, the penalty for not having health insurance is:


  • A flat fee of $800 per adult and $400 per child 
  • 2.5% of gross income that exceeds the household’s state filing threshold


District of Columbia

In the District of Columbia, residents must have health insurance or face a penalty of the following:


  • 2.5% of family income over the federal tax filing threshold
  • $695 per adult and $347.50 per child under 18, with a cap of $2,085 per family



Massachusetts residents are only penalized if they are over 18 years of age and do not have health insurance. Exceptions include those who make less than 150% of the federal poverty level. Their penalty for not having health insurance is based on a sliding scale that ranges from $276 to $1,704. 


New Jersey 

Residents of New Jersey are penalized for not having health insurance based on the number of months uninsured. The penalty can range from $695 to $3,492


Residents of Vermont do not have a financial penalty if they do not have health insurance. They do, however, have to indicate if they have insurance or not when filing taxes. 


Rhode Island 

Residents of Rhode Island must pay the following penalty if they do not have health insurance:


  • 2.5% of annual household income
  • $695 per adult and $347.50 per child under 18


Complications of the Individual Mandate

The individual mandate makes it more difficult for companies providing health insurance to keep up with state-by-state regulation and reporting requirements. For example, employers with an employee in Massachusetts must make sure that the company complies with state and federal regulations. 


Companies providing health insurance to employees in states that have individual mandates must make sure they comply with federal and state regulations in order to avoid penalties or fines.  

For more information on maintaining ACA compliance, read our article on 1094/1095 Compliance: What You Need To Know.

Innovative HIA’s Minor Medical plan (also known as Minimum Essential Coverage) provides expecting mothers the resources to screen for potential risk factors that impact the mother and baby. Some conditions or complications that arise during pregnancy are not easily recognizable and may require screening and testing for a diagnosis. It’s important to routinely check on you and your baby’s health so that if complications arise, your healthcare team is prepared to support your prenatal care. Learn more about pregnancy and minimum essential coverage – what we cover and why it’s important for you and your baby’s health in the short and long term. 

What Does Our Minimum Essential Coverage Plan Include for Pregnant Women? 

  • Anemia screening on a routine basis for pregnant women 
  • Breastfeeding comprehensive support and counseling from trained providers, and access to breastfeeding supplies, for pregnant and nursing women
  • Gestational diabetes screening for women 24 to 28 weeks pregnant and those at risk of developing gestational diabetes
  • Hepatitis B screening for pregnant women at their first prenatal visit 
  • Preeclampsia prevention and screening for pregnant women and follow-up testing for women at higher risk 
  • Rh Incompatibility screening for all pregnant women and follow-up testing for women at higher risk 
  • Syphilis screening for all pregnant women or other women at increased risk 
  • Tobacco use screening and interventions for all women, and expanded counseling for pregnant tobacco users 

What is Anemia? 

Anemia is a blood condition where the blood does not have sufficient healthy red blood cells in the body. Red blood cells carry oxygen to your organs and your baby. This means, that reduced levels of red blood cells cause lower levels of oxygen going to your body’s organs and your baby. Symptoms can include fatigue, weakness, and dizziness. 

During pregnancy, there are three types of anemia that can develop:

  • Iron-deficiency anemia
  • Folate-deficiency anemia 
  • Vitamin B12 deficiency

The most common type of anemia during pregnancy is iron-deficient anemia. In iron-deficiency anemia, the blood cells do not have enough iron in them to create sufficient amounts of the protein hemoglobin that carries oxygen itself on the red blood cell.

Therefore, the red blood cells cannot carry as much oxygen to the organs in the body, or the baby. Think of it like a train. The train with six carriages will transport double the amount of people in the same amount of time that a three-carriage train can.

Folate-deficiency anemia occurs when there isn’t enough intake of vitamin folate. Folate is a B vitamin found in food like broccoli and kale. It’s the basis for the body to make healthy red blood cells that can carry oxygen. Maintaining a consistently balanced diet replenishes folate levels in the body. 

Vitamin B12 also helps the body create healthy red blood cells. Vitamin B12 deficiency limits the body’s ability to produce healthy red blood cells that circulate enough oxygen to you and your baby. Sources of B12 are found in meat, fish, and dairy products. Again, maintaining a well-balanced diet helps protect you and your baby from potential birth complications. 

Why is Screening Important?

When screened for anemia, the test usually includes a hemoglobin test that measures the amount of iron-rich protein in the red blood cells and a hematocrit test that measures the percent of red blood cells in a blood sample. 

Severe untreated anemia can lead to pregnancy complications and potentially preterm delivery. We cover anemia screening because we know the importance of catching and monitoring anemia during pregnancy for you and your baby’s safety. 

Breastfeeding Support for Pregnant Women

After delivery, one of the first ways to assist women is through breastfeeding support and counseling. Both the American Academy of Pediatrics and the World Health Organization recommend women exclusively breastfeed infants for the first six months. 

For women who choose to breastfeed their infant, our Minor Medical plan provides breastfeeding comprehensive support and counseling from trained providers. The support includes access to breastfeeding supplies for pregnant and nursing women. 

According to the CDC, “research has shown that breastfeeding is recognized as the best source of nutrition for most infants.” 

Breastfeeding counseling encourages and supports mothers during the breastfeeding process. They help the mother:

  • Correct breastfeeding positioning, attachment, and effective suckling. 
  • Educate the mother on typical feeding behavior such as eating up to eight times a day, and signs such as rooting for when the baby is hungry. 
  • Encourage the mother to switch the breast used after each feeding.
  • Reassure the mother that she will produce enough milk for her baby. 

We encourage the use of trained providers through our Minor Medical benefits to plan to support mother and child during the important feeding process.  

What is Gestational Diabetes and Why is Screening Important?

Our Minor Medical benefits plan covers gestational diabetes screening during the second trimester and for women at risk of developing gestational diabetes. During the 24-28 week period, the second trimester of pregnancy, the pregnant woman’s body is more resistant to insulin which makes glucose, sugar, and levels rise. Women who are obese before pregnancy, or have a family history of diabetes, are at a higher risk of gestational diabetes, which makes it important for them to receive screening as well. 

Screening typically includes: 

  • Initial glucose challenge test – you drink a sugary solution and your blood is monitored an hour later to check if the levels are normal or out of range.
  • Follow-up glucose tolerance test – if the first glucose test was high, a second glucose tolerance test is taken. This one requires blood level monitoring every hour for three hours. 

It’s important to screen for gestational diabetes so you can prevent any possible future complications. If diagnosed, you and your provider can develop a treatment plan for you and your baby and monitor your health.  

Complications for the baby:

  • Excessive birth weight
  • Preterm birth 
  • Breathing difficulties 
  • Low blood sugar 
  • Obesity or type 2 diabetes later in life 
  • Stillbirths 

Complications for the pregnant woman:

  • High blood pressure 
  • Preeclampsia 
  • C-section 
  • Future diabetes 

Screening for gestational diabetes allows the mother and child to obtain the resources necessary to reduce complications in the future. 

Read on for more information about minimum essential coverage.

Infographic about Pregnancy and Minimum Essential Coverage

A study found that 70% of people don’t feel valued by their workplace. In that same study, 25% of people believed that their productivity at work would improve if they received employee benefits. When you show your employees you value their hard work, they will be more likely to strive to perform better. It’s part of why investing in health insurance for your employees is so important. 


Investing in health insurance is essential to ensuring a happy and healthy workforce. Navigating employee benefits that your employees actually want, can be a challenge. Not to mention the various requirements necessary for employers with 50 or more employees. So, why should you invest in health insurance for employees?


Learn more about Affordable Benefits, talk with one of our team members!


Employee Benefits Increase Employee Productivity

According to the CDC, employees who prioritize preventative care, such as annual check-ups, are more productive in the workplace. This may be attributed to a few different reasons. Whether they’re taking less sick time, or they’re less stressed about their health, improving focus on their work, whatever the outcome, is beneficial to you. 


As an employer, you want your employees to remain focused on their work to ensure ongoing success. Having to worry about their personal healthcare and that of their dependents drains their time and energy. While it can be time-consuming to set up proper health insurance, partnering with the right company can simplify the complexities involved.


Almost anyone in a management role knows the importance of employee morale in the workplace. A positive workforce yields positive results. One way to ensure your workforce remains positive is to provide benefits that match their needs. After all, employers who provide great benefits gain a better reputation for their business, while also increasing productivity, and decreasing turnover. 


When you partner with a broker who can guide you through the process seamlessly, health insurance doesn’t have to be complicated. They can help select plans that are right for your employees, help set up your virtual benefits, and serve as a go-to resource to answer questions that your employees may have. 


Why invest in health insurance for your employees?


How can Ancillary & Voluntary/Worksite Benefits Attract and Retain Top Talent? 

In today’s job market, employees require more than traditional benefit programs. Benefits like vision, dental, accident, term life, critical illness, and hospital indemnity insurance can provide your employees with additional coverage when they need it most.  These additional benefit options allow your employees to tailor their benefit coverage to their needs.


When employees are given the choice in their benefit programs, they are more likely to use them. And when employees use their benefits, as we said above, they are able to remain healthy and ready to work more often. 


Employees look for employers who offer voluntary benefits because these benefits give employees choice, they meet various needs of a diverse workforce, and they ensure employees remain financially stable. Offering voluntary benefits adds a level of insurance coverage that many workers have not previously had access to. Benefits beyond the traditional 401(k) and health insurance are vital to attracting the right talent for business. 


At Innovative HIA, we offer our clients comprehensive coverage that provides the complete solution for employers who want to provide affordable benefits to their workers. Service is our priority. We pride ourselves on our reliable, fast, and friendly team that makes compliance with ACA easy and affordable. 


You Remain Compliant with ACA Requirments – and Avoid Paying Hefty Fines

As an applicable large employer (ALE) you are required by the Affordable Care Act to provide benefits to 95% of your full-time or full-time equivalent employees. If you fail to do so, you will be subject to some pretty significant financial penalties. 


The Cost of Pentalty A 

If an employer fails to offer benefits to their full-time employees, they will be subject to a penalty of $2,700 per employee annually. Violations are assessed on a monthly basis. When broken down monthly, each month that an eligible employee is not offered coverage will earn you a $225. A large company with 5,000 employees that fails to provide proper benefits for its employees, could be subject to a $13,500,000 annual fine.


The Cost of Pentalty B

Penalty B is calculated for every full-time employee that was not offered minimum value coverage by their employer and went to the Health Insurance Marketplace and qualified for a premium tax credit. The annual penalty per employee in this scenario totals $4,060. Penalty B is also calculated on a monthly basis and when broken down to a monthly rate equates to $338.34 per employee. 


If a company failed to offer minimum value coverage to 100 ACA full-time eligible employees, or if the offered coverage was not affordable and they received a premium tax credit or subsidy on the exchange, the employer involved would be liable for an annual fee of $406,000.


At Innovative HIA, we have the most competitive affordable benefits available. We ensure the benefit plans you offer your employees are fully ACA compliant.  To achieve this, we process your 1094/1095s on your behalf. If there are ever any errors in your 1095 processing, we refile for you. No hassle to you, just compliant benefits.


Read on to learn more about how offering minor medical benefits is more beneficial than not. 

Article originally published on SBMA Benefits.


infographic explaining why employers should invest in health insurance for their employees

Employee benefits administration can be a pain for any HR department. At Innovative HIA, we aim to simplify the process, by giving you access to everything you need in one place. Our enrollment portal houses everything you need for:

  • Onboarding 
  • Off boarding 
  • Enrollment 
  • Portal assistance 

Our employee benefits professionals have the knowledge and expertise that can save your company time and money. We aim to offer comprehensive benefit management, not only with our portal, but also as it pertains to ACA compliance, providing low-cost options, and offering fast and reliable service.

The convenience of SBMA’s employee benefits administration support allows your Human Resources department to work on their daily tasks and responsibilities without the headache of a difficult benefits administrator. Our one-stop-shop portal helps reduce the paperwork your HR department has to deal with and therefore, improves your bottom line.

Employer Resources

Our website is equipped with plenty of employer resources that give easy and secure access to your records and the ability to make plan changes at your fingertips (i.e. (enrollment portal, adding dependents, employee termination, and more). Adjusting benefit plans couldn’t be any easier with SBMA. Additionally, every task includes video tutorials, walkthroughs, and instructions. 


Watch the videos below to see just how easy navigating our portal is. 


Enrollment portal walkthrough


Adding Dependents walkthrough 


Termination walkthrough 



Partnering with us takes the burden off of your HR department and places it on us, your benefits administrator. Ready to get started? Reach out to us today


Innovative HIA supports HR departments with onboarding, off boarding, and more

Article originally published by SBMA Benefits.

Spring is in the air. This means it’s time to spring clean not only your home but also your healthy habits. By focusing on simple ways to improve your health, you are setting yourself up to take advantage of lifelong health benefits. Implementing healthy habits is simpler than you’d think. 

Use Your Health Plan to Your Advantage 

Your health plan is a resource to be used to your advantage. Using your plan helps you stay healthy, and find any potential chronic illnesses before they become dangerous. 

Basic health insurance plans, like Minimum Essential Coverage plans, include ACA-compliant services that cover wellness, preventative services, prescription discounts, and telehealth services.  

How can you use your health insurance to spring clean your health? 

First, visit your primary care provider. Plans offer coverage for an annual checkup with your primary care physician. This annual checkup helps keep you and your healthcare team ahead of potential chronic illnesses by catching a diagnosis early. This visit allows your provider to consistently monitor your health year after year. Anything found during this visit can be addressed and monitored before it becomes more serious. 

Next, use your plan to cover routine vaccinations. They protect your body and keep you strong against viral and bacterial illnesses. It helps you reduce the risk of contracting disease or spreading disease. 

Your health plan may offer prescription discounts that make medication more affordable. If your healthcare provider prescribes a medication, stay healthy by taking your medication as directed, and save money in the process.  

Lab work and screenings act similarly to your annual physical. If the lab work or screenings flag your doctor of potential illness, catching it early can help you stay healthy, longer. 

Use Telemedicine Services

Telemedicine supports your health by providing you with cost-effective access to your medical resources. Oftentimes, telehealth copays are less expensive than an office co-pay. 

Use telehealth as an opportunity to speak with your health care team regarding:

  • Medical test results 
  • Lifestyle coaching 
  • Health coaching 
  • Consultation visits 
  • Medication management 
  • Chronic disease management 


Patients receive the same quality of care with telehealth visits as they do in a provider’s office. Taking advantage of telemedicine services supports your health, reduces time spent at the doctor’s office, and saves money. Learn more about the top reasons why you should use telehealth here

Eat Fruits and Vegetables

A well-balanced diet including fruits and vegetables, especially those in season, help promote your health. A few of the positive effects they have on your body include: 

  • Lowering blood pressure 
  • Reducing the risk of stroke 
  • Cancer prevention 
  • Reduce digestive issues 
  • Support your vision 
  • Promote weight loss
  • And more 


Easy ways to add fruits and vegetables into your daily diet are by keeping them where you can see them, and by incorporating them into a meal itself (i.e. soups, salads, and stir-fries). 

Instead of turning towards a sugary treat after a meal, try an in-season fruit. It’ll satisfy your sweet tooth and support your body’s overall health simultaneously. 

Curious if the foods you think are actually healthy for you, are? Take our quiz here to find out if the foods marketed as “healthy” are actually good for you. 

Drink Water 

Oftentimes, the answer seems to be “drink more water.”  This may be one of the best ways to spring clean your health this season because of how much it can positively impact your wellbeing. 

At a basic level, water helps your body function by: 

  • Eliminating waste through urination, and perspiration
  • Temperature regulation 
  • Lubricating and cushioning joints 
  • Protecting sensitive tissues 

Dehydration can lead to fatigue and a reduction in your body’s ability to perform the way it needs to. 

Other ways water supports your health is through:

  • Supporting brain functions 
  • Supporting your kidneys 
  • Aiding with digestion 
  • Promoting clearer skin and skin elasticity 

How much water should you drink a day? According to The U.S. National Academies of Sciences, Engineering, and Medicine men should drink at least 15.5 cups a day and women should drink at least 11.5 cups a day. One way you can increase your liquid intake is by swapping out sugary drinks for water. Your body will thank you for it.  

Walk 11 Minutes A Day 

Ideally, physicians recommend at least 30 minutes of moderate physical activity each day.  Unfortunately, the increase in more sedentary lifestyles hinders the amount of physical activity people take daily. Forbes found that the average stay-at-home employee sits for about 15 hours a day. 

Sitting for the majority of the day has detrimental effects on the body. In fact, the Mayo Clinic analyzed 13 studies and found that all found, “sitting time and activity levels found in those who sat for more than 8 hours a day with no physical activity had a risk of dying similar to the risks of dying posed by obesity and smoking.” 

A way to combat the negative effects sitting has on your health is by taking at least an 11-minute walk a day. The positive impact it has on your health is lifelong according to a study by the British Journal of Sports Medicine. They found that walking for at least 11 minutes a day actually combats the negative effects of sitting for long periods of time. 


Take Standing Breaks

As previously mentioned, sitting for long periods of time has detrimental effects on your body. Its impact is so great that it is now coined “the new smoking.” 

A few ways it hurts your body is through:

  • Leading to weight gain 
  • Muscle loss 
  • Links to lung, uterine, and colon cancer 

Learn more about the long and short-term effects here

A way to combat the negative effects of sitting is to support your health is by taking standing breaks. Ways you can do this is through:

  • Standing while working 
  • Walking during meetings 
  • Taking movement breaks
  • Stretch during the day
  • Take walks 
  • Set timers to move around 

A Final Word

Spring clean your healthy habits by implementing these habits. Together, they have a lifelong impact on supporting your overall wellbeing. For more healthy habit tips, read our article giving tips on using your health insurance to meet your health goals. 

use the resources you have, like your health plan, to spring clean your health

Article originally published on SBMA Benefits.