It’s the 9th hour and the full effects of the Affordable Care Act have yet to be crystalized for employers across the country.  At this late stage in the game….there is mounting fear, confusion and misconceptions.

In a few paragraphs, I would like to clarify what EXACTLY we need to be doing and thinking come 10/1/2013.

  1. On or BEFORE 10/1/2013, all employers subject to the Fair Labor Standards Act, are required to provide Notice of the Availability of Exchange coverage for current employees or within 14 days of an employee’s start date for employees hired after 10/1/2013.  Sample notices are available on the DOL website or from us.  We will customize your notice.  PLEASE NOTE:  you are required to give this notice whether or not you currently offer coverage to your employees.  This notice may be accomplished by first class mail or electronic disclosure under DOL safe harbor provisions.  The original legislation called for a $100/day fine for failure to notify.  That fine has been POSTPONED.  We do NOT know how long it will be postponed.
  2. NO EMPLOYER IS REQUIRED TO OFFER HEALTH INSURANCE TO ITS EMPLOYEES.  Period.  The federal government cannot mandate that you offer coverage.  HOWEVER, if you DO offer coverage, you may be subject to governance of WHAT you offer. 
  3. IF you are an employer with 50 or more employees (including FTEs) you could be subject to a “Shared Responsibility Payment” if You do not offer coverage to at least 95% of your full-time employees (and their dependent children) OR You offer coverage to your full-time employees that is not “affordable” or does not provide “minimum value.”  If you have questions about how that directly relates to you, give us a call or send us a note. THE “SHARED RESPONSIBILITY PAYMENT” has been postponed until 1/1/2015 so that employers can prepare their census information, revamp hours of work schedules, consider health care alternatives and the cost to their employees and budget for the cost. Counting your employees is NOT easy!  If you are not CLEARLY employing 50 or more full-time employees, get HELP!  There are a number of ins and outs to accurate counts.  Employing more than 50 full-time equivalent employees does not necessarily mean that they all will be eligible for coverage.  Further, it does not mean that they all must pick up coverage from you or the Individual Exchange.  The “count” determines your status as a “small” or “large” employer for ACA compliance purposes.
  4.  Employers with LESS THAN 50 employees (including FTEs) will want to review their interest in providing health insurance to their employees.  Generally, employers with less than 50 employees are NOT subject to any regulation regarding their offerings from the federal government.  HOWEVER, state and carrier guidelines will still apply.
  5. Additionally, some smaller employers will find that their employees can purchase health insurance directly through the individual Exchanges with substantial subsidies provided to them.  The subsidies may be larger than the employer contribution to health insurance they currently receive!  This will cause you, as a small employer, to rethink what you offer!  We can help you with this determination.
  6. Smaller employer eligible for the Health Care Credit when filing taxes, should seriously consider purchasing coverage through the SHOP Exchange.  This Exchange is available to small businesses.  BE AWARE:  the only way you can receive a CREDIT for providing health insurance in 2014 is through the SHOP Exchange.  No credit is available OUTSIDE of the SHOP.

We are fully licensed and certified to provide you SHOP Exchange coverage as well as direct employer provided coverage through local carriers.We will also work with you to determine which is best for YOU and your employees.

  1. If you are an employer with less than 50 employees, please note that the coverage you offered in 2013 probably has changed considerably for 2014.  Be proactive and begin to look at the coverage options immediately.  Your choices are extensive and it will be wise to review your employee’s earning with what is considered “affordable” under the new ACA regulations.  That comparison will allow you to offer coverage which meets your employees’ needs and YOUR budget!
  2. Finally, although it is encouraged that ALL employers who provide health insurance to their employees report the cost of that coverage on the employees’ W-2, only employers with 250 or more employees need to report currently.  The requirement for smaller employers has been postponed indefinitely.

As always, we remain your “GO TO” advisor for all things BENEFITS….especially your compliance with the Affordable Care Act!