Affordable Care Act and the 50 employee rule…
Morning, Jeanette here, the other day I remember seeing back and forth emails about why some employers feel they do not need to worry about the 2014 Health Care Reform Law. Some employers mistakenly think that if I have less than 50 employees, and I don’t offer health insurance any way, I don’t have to worry about Health Care Reform. Sheri Hyslop (Benefits Agent in our office,) has a couple very good reasons why all employers should be aware of the changes and rules. Such as: Businesses with fewer that 50 employees that do offer coverage will have lots of new regulations on rates, benefit design, eligibility and so forth. (What they won’t have is a penalty for not offering coverage.) Business owners of all sizes will have to inform their employees about the Exchanges and their options whether they offer insurance to their employees or not.
I wanted to share the one “big” reason why I personally feel ALL employers need to know what is happening in 2014.
March 2013 was the original due date that ALL employers, regardless of size, would need to communicate the availability of the Health Care Exchanges to their employees. This date has since been pushed back and anticipated to be either late Summer or early Fall of this year. (Not a lot of time left.)
Here is the interesting design of this whole notification process.
* Employers have to tell their employees that the Exchanges will exist and where they can go to get more information on them. The Department of Labor will have (someday) specific guidelines on how this should be handled.
* Once their employee’s reach out to the Exchange, the “snooping around” starts. One of the first steps will be for the Exchange to determine who this employee works for and if that employer is over 50 or under 50 full time employees.
* If the employer is under 50 employees but has another entity that is “common ownership”, then that employer, if they were not paying attention may be paying a fine for not offering coverage if the combined employees are over the ‘50’ threshold.
* If the employer has over 50 FT Employees and is not offering coverage, the IRS starts their investigation, which will lead to fines.
* If the employer is truly under 50 employees, then the next question is…… Is that employer offering health insurance coverage to their employees? If the answer is no, then it would seem that the snooping should subside at that point(cross your fingers,) but if the answer is yes, then a lot of other questions come up.
- Why isn’t this employee enrolled in the health plan?
- Is it because its not affordable to the employee?
- Is the employer not making it affordable to this employee, but possibly covering the cost for some of the other employees?
- Is the employer discriminating by not offering it to all full time (30 hours a week) employees?
- Did the employer offer it to this employee?
- Is there a waiver of coverage on file for this employee?
- What type of record keeping is the employer keeping to make sure that he/she is offering the coverage to all employees who are eligible?
Government entities are going to be in every employer’s business. They will be looking for compliance issues. All employers should attend at least ONE seminar about Health Care Reform.
OK, enough …… I’m going back to work just wanted to share my thoughts as well. Happy Friday. Don’t forget our Free seminar
Jeanette Fagundes is a Health and Benefits Agent at James G. Parker/Bacome Insurance Agency
For more information, and to get your specific questions answered please contact Jeanette or Sheri at their email address below.
Jeanette Fagundes – firstname.lastname@example.org
Sheri Hyslop — Sherih@jgparker.com