Customer Spotlight ACA Compliance ICHRA Direct Primary Care Health Benefits #### Table of Contents #### Related Blogs \\ Introducing ACA Autopilot: Fully Managed ACA Compliance for Employers with Hourly Workers](/content/blogs/aca-autopilot-managed-aca-compliance/index.html) \\ Self-Funded vs. Fully Insured Health Plans: What Employers Need to Know](/content/blogs/self-funded-vs-fully-insured-health-plans/index.html) \\ What happens when your home care agency is audited for ACA compliance by the IRS?](/content/blogs/what-happens-when-your-home-care-agency-is-audited-for-aca-compliance-by-the-irs/index.html) .avif)\\ Affordable Care Act FAQs for Home Care Agencies](/content/blogs/affordable-care-act-faqs-for-home-care-agencies/index.html) %20(1).avif)\\ What We Learned from the 2025 Small Business Benefits Index](/content/blogs/2025-small-business-benefits-index/index.html) written by Natasha Schuler Read: 3 mins When [Metrogreenscape](https://www.metrogreenscape.com/), an award-winning outdoor living design company in Charlotte, North Carolina, crossed the 50-employee threshold, the team found themselves facing new healthcare compliance requirements under the [Affordable Care Act](/content/blogs/what-is-the-affordable-care-act-aca/index.html)(ACA). Under the ACA, companies with more than 50 full-time employees must offer affordable health insurance, either through a traditional group plan or an [Individual Coverage Health Reimbursement Arrangement](/content/ichra/index.html) (ICHRA), a model that allows employers to reimburse employees tax-free for their own health insurance coverage. Customer Spotlight: MetroGreenscape - YouTube Tap to unmute [Customer Spotlight: MetroGreenscape](https://www.youtube.com/watch?v=fI_cDmI4lHQ) [Vitable Health](https://www.youtube.com/channel/UCakpPqe3T3WQkJ6g4eiPxEw) Vitable Health64 subscribers For Metrogreenscape, this created an urgent challenge. The company needed to comply with federal regulations while also providing a benefit that worked for their workforce of 62 employees, half of whom are hourly field staff who often struggle to afford traditional insurance. When Maureen Ancona joined as the company’s HR leader, she quickly realized that conventional group health plans were too expensive and too rigid for a small, growing business like Metrogreenscape. The team needed a smarter, more flexible solution that would satisfy compliance requirements and make healthcare accessible for everyone. “I looked at one other plan, and then the broker had recommended \[Vitable Health’s\] ICHRA,” Maureen explained. “It just seemed more straightforward and easier to deal with in terms of the dashboard, the billing, and everything. Easier to get people signed up when they were eligible and for them to understand what it was.” > “For the hourly folks, Vitable Primary Care is perfect because many of them just cannot afford health insurance . . . So this has been appreciated by that particular group and their dependents because it's there for you.” Many of Metrogreenscape’s hourly employees struggled to afford traditional coverage, even through [healthcare.gov](https://www.healthcare.gov/). The ICHRA allowed them to choose their own individual plans and get reimbursed, giving the company flexibility and ensuring every employee had an affordable option for coverage. In addition to the ICHRA, the company also began offering a Vitable Health [direct primary care](/content/primary-care/index.html) benefit, which gives employees access to virtual visits with licensed medical providers and mental health coaching at no out-of-pocket cost. Together, these programs made healthcare accessible and easy to use, something employees quickly came to appreciate. “For the hourly folks, it's perfect because you'll get a lot of them at all ages that just cannot afford health insurance, even if they're going through healthcare.gov,” Maureen said. “So this has been appreciated by that particular group and their children or their dependents because it's there for you.” At first, however, many employees were skeptical. ICHRA was new to them, and the idea of being reimbursed for their own plan seemed too good to be true. “They were very distrusting of it,” Maureen recalled. She explained that employees hadn’t heard of this kind of benefit before. They questioned how it worked and why the company would reimburse them without taking anything out of their paycheck. But once they saw new hires using it successfully, trust grew. One employee who initially refused to enroll returned to Maureen months later, ready to participate. “He said, ‘Maureen, I'm taking you up on your offer at open enrollment. I'm coming to your office and you're going to help. I should have done this like you said.’” Now, the combined ICHRA and virtual primary care benefits are working well for both the company and its people. Metrogreenscape employees give Vitable Health’s Direct Primary Care program an average net promoter score of 100 and rate providers an average of 5 out of 5 stars, reflecting the trust and satisfaction the program has built across the team. Even their staff with insurance find Vitable Health valuable for everyday health needs. “Even the salary folks like it because, you know, if you have a lot of kids and little things happen, sometimes it's quicker to get to a Teladoc,” Maureen explained. “It’s not a major issue, but you might need an ointment or a cream or something.” For Maureen, one of the biggest advantages has been the simplicity of managing everything from the HR side. “The dashboard’s good, the billing works, adding people, taking them off. It’s very user-friendly, very simple. It works,” she said. She often reminds employees about the benefit when life events happen, a child’s illness, a minor injury, or a need for quick medical advice, so they can access care without worrying about cost or waiting weeks for an appointment. What began as a compliance challenge has become a meaningful advantage for Metrogreenscape. By pairing an ICHRA with Vitable Health’s virtual primary care, the company created a sustainable, compliant, and people-centered benefits model. Employees now have real access to care, while the business stays compliant and keeps administration simple. For Maureen, that balance of care and compliance is what makes the partnership work. Metrogreenscape isn’t just meeting a requirement, it’s helping its employees stay healthy and supported year-round. ## Get a quote Get a personalized health benefits quote tailored to your company’s unique needs. 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