Healthcare Reform Basics
Overview for businesses and individuals


Healthcare Reform Basics

September 10, 2013 UPDATE

The health care reform law requires that all employers notify their employees about the availability of the new health insurance marketplace (also called an "Exchange") that is opening on October 1, 2013. The U.S. Department of Labor has posted information about the notification requirement on its website and has provided model notices that can be used both by employers who offer insurance and those who do not offer insurance.

July 2, 2013 UPDATE

The Obama administration announced Tuesday (July 2, 2013) it is delaying the employer mandate portion of the health care law for one year, until 2015.

According to the U.S. Department of the Treasury website:
Continuing to Implement the ACA in a Careful, Thoughtful Manner. We recognize that this transition relief will make it impractical to determine which employers owe shared responsibility payments (under section 4980H) for 2014. Accordingly, we are extending this transition relief to the employer shared responsibility payments. These payments will not apply for 2014. Any employer shared responsibility payments will not apply until 2015.

Large Employers

Starting in 2014, large employers will be required to provide affordable health insurance coverage for their full-time employees. Large employers are defined under the health-care law as those with 50 or more full-time-equivalent employees. Employers who do not provide affordable coverage to their employees may be liable to pay an annual penalty of up to $2,000 per full-time employee. The penalty is calculated on a monthly basis; federal agencies will need to issue regulations to explain exactly how this will work.

Small Employers

Businesses with fewer than 50 full-time-equivalents are exempt from the law's health care coverage requirements and penalties. Certain small businesses with up to 25 employees may be eligible for federal tax credits starting in 2010 to help offset the cost of providing health benefits.

Full-time Employee

A full-time employee is defined as a person who averages at least 30 hours of service per week in any given month.

Part-time Employee

A part-time employee is defined as a person who averages fewer than 30 hours a week in any given month. Employers are not required to provide health care coverage or pay penalties for part-time employees. Employers must use part-time employees' hours solely for purposes of determining whether the business qualifies for the small business threshold.

Seasonal Workers

Seasonal workers are defined as those who work 120 or fewer days a year. Seasonal employees' hours are not counted for purposes of determining whether an employer meets the 50 full-time-equivalent small business threshold. If an employer's workforce exceeds 50 full-time-equivalent employees (not including seasonal workers) the employer must provide coverage for those seasonal employees who are full-time.


Resources

The Affordable Care Act in Brief: Impact on America's Smallest Businesses

2012 Health Insurance Reform Tax Credit Calculator for Small Business

Determining Full-Time Employees for Purposes of Shared Responsibility for Employers Regarding Health Coverage

Employers Calculations

Employer FAQ's

Final Regulations Implementing Employer Shared Responsibility Under the Affordable Care Act (ACA) for 2015

Health Care Reform - Fewer than 25 Employees

Health Care Reform - Fewer than 50 Employees

Health Care Reform - More than 50 Employees

Health Care Reform - Self Employed

Health Care Reform Webinar for Business Owners

Health Care Reform Webinar for Individuals

NFIB Healthcare Playbook

PPACA Timeline

Shared Responsibility for Employers Regarding Health Coverage

SHOP, The Small Business Options Program

Health Care Calculator

What Does Health Care Mean to Me?

What Health Care Reform Means For Your business?

What Health Care Overhaul Means For You?

For more information please contact PBA's government affairs team at 800.468.2274 ext. 3451
or email Myra Irizarry.