Apothegm Software

Release of Pay or Play Tool Unaffected by ACA Delay

Danville, CA, August 5, 2013 – Employers breathed a sigh of relief as the Obama administration announced a twelve month delay in the implementation of the ACA Employer Mandate earlier in July.  While some may want to defer planning and decision making in lieu of more pressing business matters, now is the opportunity for employers to put together a more comprehensive strategy to be fully prepared for implementation.

The Employer Mandate, commonly referred to as ‘Pay or Play’, will require companies with 51 or more full-time or full-time equivalent workers to either offer eligible employees qualified coverage that meets the ACA affordability and sufficiency requirements, or incur a “Play penalty”.  Alternatively, if a large employer does not offer ACA qualified coverage it will incur a “Pay penalty”.  The mandate deferment will push the implementation of these potential penalties to January 1, 2015.  The postponement of the Employer Mandate also delays many new ACA reporting requirements.

Danville, California based health plan system developer Apothegm Software (www.apothegmsoftware.com ) announced today the beta release of an online tool named PoP Navigator, or ‘PoP’ for ‘Pay or Play’, that empowers large employers to understand and manage many of the potential impacts of ACA.  Apothegm plans to provide access to a limited number of customers, at a discounted fee, for early testing and trial forecasting.  The release of the full application is expected by early fall.

PoP offers a wide range of functionality beginning with a financial assessment of each employee and health coverage offered by an employer. PoP forecasts health plan affordability, sufficiency, employee migration, and potential penalty risks using a robust actuarial evaluation tool. It also includes analysis of exchange subsidy and expanded Medicaid qualification for employees, considerations for grandfathered plans, and calculation of any expected excise, or ‘Cadillac’, tax

PoP’s actuarial engine includes features such as rate and contribution forecasting, alternate benefit design modeling, and estimated actuarial plan value.  Users can easily target any ‘Metal level’ plan value and view its impacts to premium, employer cost, penalties, and incremental corporate income taxes.  Packaged with a library of reports, PoP provides detailed analysis and executive summary information for each year from the present plan year through 2018 needed to navigate ACA and make critical business decisions.  Reports include legislative background as well as a tutorial of the decisions and processes PoP uses to arrive at its results.

Further information regarding PoP Navigator, its features, sample reports, and purchasing a subscription may be obtained by visiting Apothegm’s website or at www.shouldipayorplay.com.



Ryan de la Gente

(925) 627-6000




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