The ACA (Affordable Care Act, aka Obamacare)
The ACA requires health plans and policies to meet specific coverage, eligibility and cost-sharing requirements. The ACA may also subject employers to penalties if they do not offer their full time employees health care coverage that is affordable and that offers minimum essential coverage. Get more info at http://healthcare.gov
Securing a group health insurance policy for your company
If your company employs less than 50 full-time employees (including full-time equivalents), you are not subject to the employer mandate penalties and have no obligation to offer health insurance, although offering health insurance is a great way to attract and retain employees. If you do not offer health insurance, you may also want to educate your employees about their options (exchange, agents) since individuals who do not have health care coverage may be subject to a penalty.
For employers with more than 50 full-time employees (including full-time equivalents), and are therefore subject to the employer mandate, the fine for failing to make an offer of health coverage to an employee can be between $2,260 and $3,390 per employee that was not made an offer of coverage.
You can have access to medical, vision, and dental plans nationwide at affordable rates, so your company and employees can avoid costly penalties - without breaking the bank. You can find more information here.
Employee contributions to an employee group health insurance policy
In order to make an offer of coverage and avoid employer mandate penalties, the offer must be affordable. For plan years beginning after January 1, 2018, health care coverage will not be considered affordable if an employee is required to contribute more than 9.56% of the employee’s household income. You can find additional information on the government website listed above or a member of our team would be happy to discuss the types of insurance you may have access to.
Helping employees connect with an individual healthcare policy
Since health insurance can be a very confusing and emotional product any help you can provide for your employees will be seen in a positive light. Employees may be subject to the individual mandate if they do not have health care coverage. In 2017, the amount of the penalty will be the greater of (1) 2.5% of the taxpayer’s household income up to the total yearly premium for the average price of a bronze plan or (2) $695 per adult and $347.50 per child up to $2,085 per household.
For example, individuals and families may be eligible to receive health insurance subsidies or tax credits to obtain coverage and avoid penalties.
ACA reporting at tax time
Applicable Large Employers or “ALEs” are companies with 50 or more full-time employees or equivalents according to this calculation. Companies of this size have to report their employer-sponsored health insurance offerings to the IRS by filing Forms 1094-C and 1095-C. An ALE must also provide employees with a Form 1095-C by January 31of the next year that details any coverage that an employee was offered during the previous year and whether or not they were covered for each eligible month. Both of these forms are filed with the IRS to show the company is in compliance with the ACA.
If you’ve been on Justworks since the beginning of 2016 and are an ALE according to our records, we file everything on your behalf, and you will hear from us. If you haven’t heard from your Account Manager, Justworks won’t be filing anything on your behalf. If you aren’t sure whether your company is an ALE, you should check with your legal counsel before the end of the year.
If you are not an ALE, you don’t have to worry about ACA reporting. Your insurance carrier will be filing 1095-B forms with the IRS for your employees. Your employees will receive copies directly from your insurance carrier with information about their coverage that they can keep for their records and there’s nothing you need to do.
This material has been prepared for informational purposes only, and is not intended to provide, and should not be relied on for, legal or tax advice. If you have any legal or tax questions regarding this content or related issues, then you should consult with your professional legal or tax advisor.