Learn about the comprehensive strategies that Maxwell supports below, along with some of the strategies that we’re working on supporting in the future.
This article will review:
- Supported contribution strategies
- Supported financial product contribution strategies
- Contribution strategy limitations
- Unsupported contribution strategies
Flat Dollar or Percentage
The employer contributes a flat dollar or percentage amount for every employee who chooses the plan. Every employee will get the same contribution amount applied regardless of any factors (coverage level, age, region, etc.)
- ABC Employer contributes $100 dollars towards the cost of a medical plan for each employee
- ABC Employer contributes 5% of the premium of the medical plan cost for each employee
Individual Contribution Type ($ or %) and Amount per Role
The employer or the employee contributes a different contribution type (flat dollar or percentage) and amount per role (employee, spouse, domestic partner, child). This contribution strategy is for age-banded and individually banded plans. We can support coverage level banded plans, but only if the contribution type is flat dollar. We can also accommodate rates based on smoking status or wellness program participation.
ABC Employer or the employee contributes:
- 75% toward employee-only coverage
- $50 toward the spouse premium
- $25 per child premium (up to a defined maximum number of children)
Employee vs. Dependents
The employer contributes a flat dollar or percentage amount to the employee, and a different amount to the employee’s dependents—spouse, domestic partner, child(ren), or any combination. In this instance, dependent amount is defined as the total premium for a coverage level that has dependent included, minus the premium for the employee only. The employer can even use different strategy types (dollar or percentage) per role, so the employer could pay with a dollar amount for the employee portion of coverage, but a percentage of the premium for dependents.
ABC Employer contributes $100 towards the employee portion and $50 towards the dependent portion. Therefore,
- If the employee elects employee-only coverage, then the employer will contribute $100 towards the cost of the premium.
- If the employee elects employee plus any single dependent, or combination of dependents, then the employer will contribute $150 towards the cost of the premium.
Flat Dollar or Percentage per Coverage Tier
The employer or the employee contributes a flat dollar or percentage amount that based on the coverage level the employee selects (employee only, employee+spouse, employee+child, family, etc.). We can also accommodate rates based on smoking status or wellness program participation.
ABC Employer of the employee contributes:
- $100 for employee-only coverage,
- $150 for employee+spouse coverage,
- $160 for employee+child coverage, and
- $200 for family coverage
The employee’s contribution to one plan is a buy-up from another plan. In this case, the employer contributes (fully or a portion of) to a base plan (Plan A). That contribution amount is applied to another plan (Plan B). Therefore, the employee pays the difference of the full cost of Plan B, and the employer’s contribution from Plan A.
- A buy-up contribution strategy cannot be used for products that apply age reduction to the benefit
- The base plan must be an eligible product for any eligibility group that is using this contribution strategy
An employer pays 100% of the cost of the base plan (Plan A) for employee only coverage, which is $150. The buy-up plan (Plan B) costs $250, so the employee would need to pay $100, which is the difference between the cost of the base plan and the buy-up plan.
The employee’s contribution to one plan is a buy-down from another plan. In this case, the employer contributes (fully or a portion of) to a base plan (Plan A). That contribution amount is applied to another plan (Plan B). Leftover funds from the base contribution are automatically applied to any covered dependents of that plan (and cannot be applied to the employee only).
An employer pays 100% of the cost of the base plan (Plan A) for employee only coverage, which is $150. The buy-down plan (Plan B) costs $100. Then, $100 would be applied to the employee cost, and if there are any dependents, the remaining $50 would be applied to them.
Supported Financial Product Contribution Strategies
Flat Dollar Employer Contribution for All Employees
The employer contributes a flat dollar amount monthly or annually. This contribution is made regardless of any employee contribution (for HSA, FSA, LFSA or DCA products only).
Separate Flat Dollar Employer Contribution by Coverage Tier
The employer contributes a flat dollar amount monthly or annually that depends on the coverage level (employee only, employee+spouse, employee+child, family, etc.) selected by the employee for the associated medical plan.
Dollar for Dollar with Maximum
The employer matches the employee’s contribution dollar for dollar, up to a defined dollar amount. (For FSA or HSA products only.)
Full Dollar for Dollar
The employer matches the employee’s contribution to an HSA, FSA, or DCA with full dollar for dollar match.
Commuter Employer Contribution
The employer contributes a different contribution amount per commuter plan (transit, parking, or biking).
NOTE: Employer contributions for financial plans can be prorated on a per pay period basis. If an employer's payroll frequency is biweekly, we cannot prorate on a monthly basis.
There are some limitations to what we can implement. If you’d like to implement an employer using one of the strategies below, or another unique strategy not listed here, please contact your Maxwell Health team for guidance.
Spousal surcharge, where contribution amounts based on whether or not the spouse already has existing coverage.
A contribution strategy where if you select or enroll in one type of product (e.g. dental), you get a discount on another type of product (e.g. vision).
A percentage value up to a maximum dollar value, ie. 70% of an employee’s premium up to $500.
Unsupported Contribution StrategiesWhile we support many contribution strategies, there are a few that we’re still working on supporting, but cannot currently implement. We have listed the most common requests below.
- A mix of different contribution strategies on the same product. Ex: ABC Employer contributes 90% up to $500 of a medical plan premium
- A contribution strategy where the employer contributes x% for the first $xx and y% for the next/remaining $y. For example, a strategy in which ABC Employer contributes 90% of the first $375 of a medical plan premium, and then 60% of the next $1,125 of the total premium for all employees.
- An HSA contribution strategy where the employer contributes on a cycle that does not follow the payroll frequency (i.e. on a quarterly basis). You can include some information in the description of the product to let the employee know when the employer contribution will take effect.
- An employer contribution of xx% for an employee, but $yy per dependent if the premiums are based on coverage tier. We can support this if the premiums are individually age-banded.
- A medical plan contribution that's a multiple of the employee's salary.
- Minimum employee contributions for commuter products.
- For commuter products, while you can contribute different set amounts to each product (parking, transit, biking), you cannot contribute one bucket of funds ($500) and allow the employee to decide how they want to use it across all three products (i.e. $100 for biking, $300 for parking, and $100 for transit).
- Interaction between commuter products. Ex: if an employee selects a biking product with a $50 employer contribution, they'll automatically receive a $50 contribution amount for the parking and/or transit product as well.
- At this time we are not implementing any more new employers with defined contribution strategies.