The Moritz Group, PC
Certified Public Accountant
How does the Affordable Care Act (Obamacare) affect my business?
Employer Mandate
Applicable Large Employers are required by the ACA to offer affordable health insurance coverage to full-time employees.
The term "Applicable Large Employer" includes any employer that has 50 or more full-time employees and full-time equivalent employees.
Use this Excel template to find out if your business is considered an Applicable Large
Employer. (Special rules may apply to related, or affiliated, businesses.)
Use 2014 payroll information to find out if you are an Applicable Large Employer for the
year of 2015.
Use 2015 payroll information to find out if you are an Applicable Large Employer for the
year of 2016.
If Applicable Large Employers do not offer health insurance coverage, they may be subject to penalties. These penalties are called Employer Shared Responsibility Payments.
Employer Shared Responsibility Payment
An Applicable Large Employer may be subject to penalties if affordable and adequate coverage is not offered to full-time employees. These penalties are called "Employer Shared Responsibility Payments."
The health insurance offered to employees must meet standards set by the ACA.
It must be "Minimum Essential Coverage."
It must meet "Minimum Value" according to a specific definition under the ACA.
It must be affordable according to a specific definition under the ACA.
If the Applicable Large Employer does not offter coverage to full-time employees, or does not offer affordable and adequate coverage, the penalties may be $2,000 or $3,000 annually per employee violation.
These penalties will be triggered if an employee goes to the health insurance exchange and receives a subsidy from Healthcare.gov.
Small Business Options
For employers that are not in the "Applicable Large Employer" category, the SHOP Marketplace may provide alternatives for offering employee coverage.
The Small Business Health Options Program (SHOP) Marketplace is for employers with 50 or fewer
full-time and full-time equivalent employees.
Although small businesses are not required to offer coverage to employees, it may be beneficial to
check out the SHOP Marketplace or the Healthy Indiana Plan in order to see what is offered within
those programs.
If a small business has fewer than 25 employees, it may qualify them for a Small Business Health
Care Tax Credit.
Reporting Requirements
Applicable Large Employers are not only required to offer certain coverage to full-time employees, but they are also required to report this information to the government.
Beginning in 2016, these employers need to do the following for the 2015 year.
Provide a health insurance statement to each full-time employee by the end of January. For fully-
insured employers, this is called a Form 1095-C.
Report to the IRS the health insurance coverage information for full-time each employee.
For fully-insured employers, this includes Form 1095-C (for each full-time employee) and Form
1094-C (for the employer). This is due by the end of February if reporting is done on paper by
mail. The due date is the end of March if filing the reports electronically.