Learn more about StarMed Benefits in the video below:

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Answers to Frequently Asked Questions by Large Employers

(Applicable large employers with 50 or more full-time employees or full-time equivalents)

An employee who works an average of 30 or more hours per week is considered a full-time equivalent employee and therefore is 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 offered health benefits.

In order to be compliant with the law, a plan featuring minimum essential coverage that is of minimum value must be provided to your employees. We offer our Basic Plan, Mega Plan, and MVP Plan to fulfill these requirements.  Our most popular selection is the Mega Plan which encompasses the law-compliant components. If you have additional questions, please contact us at Admin@starmedbenefits.com or our toll-free line at (888) 616-2131.

The Employment Retirement Income Security Act of 1974 (ERISA) requires employer sponsored health care plans provide for Minimum Essential Coverage. We recommend and encourage the employers to fully cover the cost of the Basic Plan, although the employers are required to contribute at least 50% of the Basic Plan.

StarMed Benefits requires a monthly maintenance fee for any eligible employee working 30 or more hours per week who has waived their offer of coverage. This monthly maintenance fee is required to cover plan administration costs, which include:

  • Offer documentation and evidence of waiver
  • The cost of the notifications
  • Affordable Care Act and ERISA compliance documentation
  • PCORI annual fee filing fees
  • COBRA notices
  • Third-party administrator (TPA) fees
  • Forms preparation and filing fees
  • Annual reports filing fees

These functions apply to all employees and not just those enrolled in medical plans. All employees must have an offer notification and enrollment documents must 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 basis. StarMed Benefits assists in responding to requests from the regulators, files dispute and appeal paperwork, and assists the employer with their compliance.

Absolutely! Our health care 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 StarMed Benefits during the calendar year would be after a qualifying event such as birth, marriage, death or divorce in the family, or if an employee is terminated from the company.

Employers log into the employer portal and update their monthly employee census by the 24th of each month. StarMed Benefits generates and sends out a monthly invoice based on the updated census. Payments are processed by ACH withdrawal prior to the 10th of the month. Employers should review their online invoice and contact StarMed Benefits with any changes by the 1st of the month to avoid any errors in the billing and payment collection process.

If you decide to choose another health care partner to take care of your benefit needs, StarMed Health Benefits requires a 30-day, written notice with explanation for termination of services. Please send any cancellation notices to Admin@StarMedBenefits.com.

Answers to Frequently Asked Questions by Small-Business Employers

(1-49 employees)

We suggest offering all plan options to your employees. We offer our Basic Plan, Mega Plan, and MVP Plan.  Our most popular selection is the Mega Plan. These plans are set up to offer coverage and price range for employees that may have different health care needs within the same company. The main choice an employer needs to consider on an employee’s election form is the amount of contribution toward the different benefit plans. If you have additional questions, please contact us at Admin@starmedbenefits.com or our toll-free line at (888) 616-2131.

The Affordable Care Act (ACA) regulation does not apply to small businesses (employers with 49 or fewer full-time employees) in the same way that it applies to Applicable Large Employers (ALE) with 50 or more full-time employees. StarMed Benefits’ programs are, however, bound by the laws of the Employment Retirement Income Security Act of 1974 (ERISA). This ERISA legislation requires self-funded benefits be employer sponsored. We encourage the employer to pay the full Basic Plan contribution; however, the minimal employer contribution is at least 50% of the Basic Plan per employee, per month. An employer is free to increase their contribution amount at their discretion. Employees who choose to participate in plans with fewer than 50 employees will be required to have tax forms provided to them and to the IRS. StarMed Benefits will assist in the preparation of these forms with the employer.

For an employer of 49 or fewer full-time employees, offering healthcare coverage is not mandated by the Affordable Care Act (ACA) at this time. However, the Employment Retirement Income Security Act of 1974 (ERISA) governs self-funded benefits that are offered through StarMed Benefits. ERISA proposes plans be employer sponsored, and a contribution from the employer on behalf of the employee has been set at 50% of the Basic Plan per active employee, per month, at StarMed Benefits. Additionally, if health care 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 health care coverage (by their 90th day of employment). If the company grows in size to exceed 50 full-time employees or the equivalent thereof (6,000 monthly hours), guidelines from the ACA will then apply.

Absolutely! Our health care 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 StarMed Benefits during the calendar year would be after a qualifying event such as birth, marriage, death or divorce in the family, or if an employee is terminated from the company.

Employers log into the employer portal and update their monthly employee census by the 24th of each month. StarMed Benefits generates and sends out a monthly invoice based on the updated census. Payments are processed by ACH withdrawal prior to the 10th of the month. Employers should review their online invoice and contact StarMed Benefits with any changes by the 1st of the month to avoid any errors in the billing and payment collection process.

If you have decide to choose another health care partner to take care of your benefit needs, StarMed Health Benefits requires a 30-day, written notice with explanation for termination of services. Please send any cancellation notices to Admin@StarMedBenefits.com.

Our online enrollment process is easier than ever to navigate. Simply visit the StarMed Benefits homepage and click on the “Enroll now” button. Enter your contact and tax information as requested on the first page and click “continue” to proceed to the election process. Note, if you currently file your taxes under an EIN number, please provide this number so we can appropriately issue your relevant health care tax forms at the end of the year. On the second page of enrollment, enter “Company Code: INDIVIDUAL” to generate the pricing options. Then select the health care options that are best suited for you and your family. The third page of enrollment allows you to set up your online auto-draft for your monthly payment. At this time, only ACH bank-authorized transactions are available for payment options. No credit card payments are permitted.

Answers to Frequently Asked Questions by Employees

All employees that work a minimum of 30 hours per week and/or are 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 at their employer’s discretion, but they may be responsible for the full cost of the program. Please check with your employer regarding their contribution level.

The Basic Plan or Mega Plan 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 in the MVP plan until the next open enrollment period, unless you experience a qualifying event such as birth, marriage, death or divorce in the family, or if an employee is terminated from the company.

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 StarMed Benefits. StarMed also conducts an annual membership-wide open enrollment from October 15 through December 15 of ever year. In September, StarMed Benefits will notify you of any new plan options or changes. If StarMed Benefits is not contacted with changes, your account will auto-renew.

Once you begin coverage with a benefit plan at StarMed Benefits, you must stay enrolled in the program for at least 12 calendar months following your first day of coverage. You will not be able to change these elections for the Basic or Mega Plans until the next annual enrollment period unless you have a qualifying event such as birth, marriage, death or divorce in the family, or if an employee is terminated from the company. In order to cancel your coverage following your yearlong introductory period, StarMed Benefits must receive written notice of your intent to cancel 30 days before your next billing cycle as well as the reason for cancellation.

Monthly benefit plan fees will be deducted through payroll deductions. If you miss a payroll deduction as a result of absence, lack of work or termination, you risk being cancelled from your selected plan. If the plan is cancelled, you will not be eligible to re-enroll in the Minimum Value 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 monthly fees are made current.

We are proud to offer employees three easy ways to elect coverage:

Paper: You will be provided an open enrollment packet during your open enrollment period. Attached to this document will be a paper election form for family and dependent coverage. Please fill this out and return it to your company representative, or email it to Admin@StarMedBenefits.com.

Online: Visit the StarMedBenefits.com website and click on “StarMed Benefits login” at the top of the page. Then click on “Employee login” and enter the employer identification number 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 make your health benefit selections by phone, call the StarMed Benefits office at (888) 616-2131, where both English- and Spanish-speaking representatives are standing by to answer your call.