The applicability of the play-or-pay mandate in 2015 is one of the most complicated and confusing aspects of the ACA and it will affect virtually every employer and employee in the U.S. in some way. The key question is: How can you know if your company has to provide health care to staff next year or face a penalty?

HCRx' Pay-Or-Play Advisor is the most comprehensive decision support tool for your ACA pay or play strategy. It provides you with a 360 degree assessment of all your healthcare coverage options with detailed financial impact analysis.

  • Actuary Certified

  • Actuary certified calculations
  • Financial cost impact analysis for multiple scenarios
  • Intuitive executive and tactical reports
  • Simple Microsoft Excel based data collection
  • Decision tree to develop optimized ACA benefits strategy
  • ACA compliant time management for FTE/ALE determination
How can HCRx simplify your ACA burden?
Learn how HCRx can be a vital asset for benefits advisors in assisting their clients

Mutiple business cases supported

  •   Determining ALE status (FTE determination)

  •   Financial impact of not offering minimum essential coverage

  •   Financial impact of offering minium value coverage

  •   Comprehensive analysis including multiple scenarios to help determine eventual strategy

  • Your client(employer) provides the required information in an Excel file to run a simulation.

  • Pay Or Play Advisor validates, calculates and provides you with a simple and intuitive executive summary of results.

  • You review, download actuarial results and recommendations, and share with your client(employer).

Key Calculations

  • FTE and ALE determinator

  • Plan actuarial value

  • Employee participation projection

  • Cost change modeling

  • Penalty exposure


  • Current plan projection

  • No minimum essential coverage

  • Minimum value plan

  • Silver, Gold, Platinum value plans

  • What-if planning

Reporting & Documentation

  • Actuarial certification

  • User friendly web interface

  • Detailed financial analysis report

  • Intuitive data input form

  • Integrated with ACA checklist

  • Details

  • HIPAA Compliant
  • Hosted service (SaaS)
  • Secure Connection (Https)
  • Data encryption and security
  • Plug-n-Play with no IT or setup cost
  • Single SignOn
  • Role based access
  • Archival and purge services