Employer Benefits Guide
For Child Care Businesses A smarter way to cover your team
Don't let high premiums undermine your ability to offer great health benefits.Health insurance feels complicated and expensive โ but you have more options than one fat premium. Start with the simplest question: do your staff qualify for Medicaid? Then climb only as far as your budget needs โ up to a full three-piece plan with Amaze, Bona Vita, and ClaimLinx. We did the research into what works, so you don't have to. Start here ยท cheapest first
Benefits you can actually affordMajor medical isn't the right starting point for every program โ and it doesn't have to be. Climb only as far as your budget needs, cheapest first, beginning with the most important question of all: do your staff already qualify for free or subsidized coverage?
2026 reality
The enhanced ACA subsidies expired at the start of 2026. Premiums themselves stayed about flat โ but what subsidized enrollees pay out of pocket roughly doubled, up about 114% on average. For most small owners the win isn't funding major medical โ it's (1) connecting staff to coverage that's free to your business, and (2) adding one affordable benefit that punches above its cost. The ECEA plan and Amaze are open to any Colorado child-care program โ membership isn't required. 1 First โ do they qualify for Medicaid?~$0 ยท your timeBe the navigator. Help staff enroll in coverage that costs your business nothing โ Health First Colorado (Medicaid) for staff under ~138% of poverty, CHP+ for their kids, and Connect for Health Colorado (plus Colorado state subsidies) for everyone else. 2026 Health First Colorado (Medicaid) limits at 138% of poverty; add ~$7,839/yr per extra person. Kids usually qualify for CHP+ at far higher income โ roughly up to $85,800/yr for a family of four. Owner cost: Just your time helping them enroll โ no premium outlay.
Watch: Offering a group plan or an "affordable" QSEHRA can actually disqualify staff from Medicaid or subsidies โ for the lowest-paid, helping them enroll is often the best outcome.
2 Offer Amaze on its own$32 / emp / moVirtual primary care, urgent care & mental health for about the price of a phone line. Not insurance, but it handles the large majority of day-to-day needs, cuts missed shifts, and is a real recruiting & retention perk โ and it covers the employee's whole family, kids to age 26. Owner cost: Flat $32 per employee / month through ECEA.
Watch: It's a care membership, not major medical โ keep that clear with staff. Pairs well with the navigator step above and below.
3 ClaimLinx (QSEHRA โ a small tax-free allowance)Small fixed $Under 50 employees and no group plan? Give staff a monthly tax-free allowance toward their own coverage & medical bills. No minimum funding โ set $25, $50, whatever fits. Tax-free to you and them, with no payroll tax (2026 caps: $6,450 individual / $13,100 family). Owner cost: Whatever amount you choose, up to the cap โ you control it.
Watch: The allowance offsets a worker's marketplace subsidy, so it fits best for staff who aren't getting big credits. Coordinate per employee.
4 ECEA pooled plan โ group health insuranceYou set the splitReal group health insurance at pooled pricing. You decide the split โ the business pays, employees pay, or any mix you set up. With 2026 out-of-pocket costs up sharply for subsidized enrollees, the pooled rate may finally beat buying solo. No employee minimum โ even a group of one can enroll. Owner cost: Whatever split you choose โ from fully employee-paid to employer-supported.
Watch: Compare the pooled rate against each worker's subsidized marketplace option.
Mix & match โ these aren't either/or. Most programs combine two or more rungs; the Medicaid question + Amaze is a great first step. It's complicated โ but you don't have to figure it out alone. ECEA will help anyone determine what will work to improve their budget. When you're ready for full coverage
The three-piece plan โ the top of the ladderWhen a real group health plan makes sense, this is the comprehensive option: three pieces that work together to lower your cost, protect your budget, and keep what your team doesn't use. The big idea
Stop paying one fat premium whether your team uses it or not. Put in a lower-premium plan, let everyday care get handled cheaply up front, and fund only the claims that actually happen โ so what your team doesn't use stays in your business. The three pieces
What each one is, at a glanceThe front door
Amaze$32/mo for the whole family. Virtual urgent care, primary care & mental health โ so most needs never become a claim. Visit ECEAVR.com →The insurance
Bona VitaA leaner, lower-premium major-medical plan. Hospital, surgery, specialists โ catastrophic claims stay fully covered. See the plan details →The money manager
ClaimLinxSelf-funds the gap, hunts down rebates, and adds Section 125 pre-tax savings. Whatever's left over is yours to keep. ~50%average savings on
Email Dawn to get started →
employers' healthcare costs How it works
Follow a care need from the top downEach need is caught at the cheapest level that can handle it. Most stop at the very first step. 1
Start here โ Amaze, the front door$32 / monthCovers the whole family (kids to 26). Virtual urgent care, primary care & mental health.
What it does for your wallet
Most needs end right here โ $0 per visit, and it never becomes a claim on your plan. 2
Bigger needs โ Bona Vita, the insuranceReal major medical โ hospital, surgery, specialists, labs, imaging.
What it does for your wallet
A lower, pooled premium than a fully-insured renewal โ real coverage at a group rate. Bona Vita is the usual fit โ but ClaimLinx can bring other insurance carriers too, if one suits your team better. 3
Behind the scenes โ ClaimLinx, your money managerA secondary plan (Section 105 MERP) that self-funds the gap and reimburses staff, with a Section 125 pre-tax setup. It doesn't just process claims โ it actively hunts down rebates, manufacturer assistance, and lower-cost options on the care your team uses.
What it does for your wallet
You fund only the claims that actually happen, and every rebate ClaimLinx digs up stays with you. Whatever's left at the end is yours to keep โ and Section 125 trims payroll & income taxes on top. A real example
A teacher's child spikes a fever at 9 pm. She opens Amaze โ video visit, $0, prescription sent. Nothing hits your plan. Had it needed a specialist, Bona Vita covers it and ClaimLinx fills her out-of-pocket gap โ chasing any rebate available โ and you only fund the care actually used. Why it saves money
A leaner plan you only fund when it's usedFigures below are illustrative, per employee, per month โ round numbers to show the shape, not Bona Vita rates. $1,000
Before
fully insured $800
With all 3
$670 premium + $130 gap
You save about
$200 /employee/mo
You stop paying the carrier's margin on care nobody used. You keep what your team doesn't use โ unused dollars stay in your business. Amaze handles routine care first, so fewer claims ever reach the gap. Section 125 makes it pre-tax โ lower payroll & income taxes. Your downside is capped
Catastrophic stays insured by Bona Vita, the MERP gap is capped, and Amaze keeps claims low. A heavy year shrinks your savings โ it can't blow up your budget. See your numbers
Team size
12
Illustrative savings at $200/employee/mo
$2,400 /month
โ $28,800 a year back in your business
It won't overwhelm you
You coordinate. The partners administer.Almost everything runs on a partner. Your few tasks are the same ones any plan already asks of you. Roll it out in 3 stages
1 Start with Amaze. Turnkey, instant goodwill for your staff. 2 Add the Bona Vita plan at renewal โ normal enrollment. 3 Layer the MERP + Section 125. ClaimLinx runs the setup. What your team sees
Show their card, pay little or nothing โ no claim forms, no clearinghouse maze. One simple flow. For most visits they tap an app and talk to a clinician in minutes. The complicated parts stay invisible to them โ and to you. Backing up your team
Why Amaze works so well: your team's self-pay rightsAmaze and the cash-pay approach win because the law already gives every patient the right to step off the insurance conveyor belt. When your staff pay for a visit directly, they turn a tangled third-party claim into a simple retail purchase โ they're the buyer, the provider is the seller, and the insurer has no say. Share this with your team so they get the most from their benefits. Your privacy right ยท HIPAA & HITECH
Under 45 CFR ยง164.522(a)(1)(vi), you can require a provider to withhold your health information from your insurer โ on one condition: you pay in full. Pay cash and ask them not to bill insurance, and they're federally barred from sending the claim. Your right to a price ยท No Surprises Act
If you're uninsured or declare yourself self-pay, the provider must give you a written Good Faith Estimate of expected charges before care is rendered. You know the price first. Why it pays to use it
Beat the "discount" illusion The cash price is often lower than the rate the insurer negotiated, bypassing inflated chargemaster pricing. Total cost certainty The Good Faith Estimate tells you your exact liability up front. If the bill exceeds it by $400+, federal law lets you dispute it. Real data privacy Pay cash and the visit is never digitized into a claim or fed into your insurer's risk algorithms. If a provider refuses, don't back down
Resistance is usually structural, not personal โ front desks are trained to scan a card. The law is on your side. Escalate in three steps: 1 Cite the law. "I'm exercising my right under the No Surprises Act to a Good Faith Estimate as a self-pay patient, and my HIPAA right under 45 CFR 164.522 to restrict disclosure of this visit to my health plan." 2 Ask for the right person. Clerks rarely know these laws. Ask for the clinic's Privacy Officer, Compliance Officer, or Director of Revenue Cycle. 3 File a federal complaint. Refused an estimate, or billed after paying in full? Use the contacts below. No Good Faith Estimate CMS No Surprises Help Desk 1-800-985-3059 Billed against your instructions HHS Office for Civil Rights hhs.gov/ocr/complaints The winning combination
Lower fixed premium + pay only for care that's used + fewer claims + tax savings + capped risk = a cheaper, more predictable plan โ without cutting what your staff feel. Talk it through with Dawn
Questions, concerns, or ready to set up a meeting? Dawn will walk you through which pieces fit your program โ and you can start with just one.
Together We Are Stronger.
ECEA partners with Bona Vita Benefits and Amaze Health, and those partnerships help support our work on behalf of Colorado child-care programs. This guide is general information to help ECEA members understand how these programs fit together โ it is not insurance, legal, or tax advice. Savings depend on your group, plan design, and which pieces you use; the chart uses round illustrative numbers, not Bona Vita rates, and cash flow is variable since you fund claims as they occur. Some designs (for example, pairing a MERP with an HSA) don't mix. Amaze is a virtual-care membership, not major-medical insurance. The self-pay section is general consumer information, not legal advice; rights may interact with state law, and Good Faith Estimate timing rules apply to scheduled, non-emergency care. Medicaid, CHP+, and marketplace-subsidy eligibility depend on each employee's income and household, and offering certain benefits (a group plan or QSEHRA) can change that eligibility โ confirm per employee with a navigator or tax professional. The 2026 figures reflect IRS/ACA rules as of mid-2026 and may change. Confirm specifics and current rates with ECEA and each partner before deciding. |