Monthly Archives: February 2014

New Employer Relief- 50- 99 employees and over 100 employees!!

Final Rule Provides Relief for Businesses until 2016

Businesses employing 50-99 full-time employees now have until Jan. 1, 2016, to provide health insurance, according to a final rule by the Internal Revenue Service. To qualify for the extension, businesses must certify they did not shrink their workforce to avoid compliance or materially reduce previously offered coverage.

In addition, larger firms with 100 or more full-time employees are now able to phase in the percentage of full-time workers they are required to cover, from 70 percent in 2015 to 95 percent in 2016 and beyond. The definition of a full-time is still defined as 30 hours per week/130 hours per month.

Those that do not meet these requirements will be subject to tax penalties.

The final rule contains additional transitional relief and language on counting of hours, employer reporting requirements under IRC 6056, staffing companies, volunteers, interns, commissioned staff and on-call staff. You can also view the Treasury Department’s Fact Sheet.

March 31st 2014- End of Open Enrollment!!

What if you still want coverage, but didn’t enroll for a Jan. 1 effective date?

You have until the end of the open enrollment period, March 31, 2014, to enroll in either an on -( you are eligible for tax credits,etc with ACA) or off– (not eligible for tax credits,etc) marketplace plan.

If you need a plan effective by …

April 1, 2014 You need to enroll by…March 15, 2014
May 1, 2014 You need to enroll by…March 31, 2014

Get your tax credit details and quotes at Eric’s insurance web site:

INDIVIDUAL MANDATE-Open Enrollment- Individuals/families- ends 3/31/2014!!

The concept of an “Individual Mandate”: is to ensure that there is full participation by all US citizens unless they are exempt.

To avoid the penalty laid out in the ACA ( Affordable Care Act) for individuals and families not having any appropriate health insurance , an Open Enrollment Period (annual enrollment period)  is in effect through 31st March, 2014 on exchanges run by either your state or the federal government-( in Arizona- .

HOWEVER, the tax penalty will not be levied against individuals/families:-

  • Who already have qualified coverage through an employer sponsered plan, through an exchange or directly from an insurance company.
  • Who ar>e enrolled in Medicare or Medicaid.
  • Who are covered by a military plan,
  • Who are dependents of active military enrolled in a TriCare plan,
  • Who express religious objection,
  • Who are in prison,
  • Who are members of Indian tribes;

An individual/family would not be subject to the Individual Mandate requirements if they are without coverage for less than 3 months or if the Secretary of HHS determines that obtaining coverage would constitute an extreme hardship for the individual also if an individual would contribute more than 8% of their household income as a “required contribution” that person is likewise excused from the Individual Mandate.

After the 3/31/2014 , enrollment( or plan change)  is only available in”special enrollment periods” or until the next “annual enrollment period”.

Finally- no more restrictions on “pre-existing conditions”!!. 

ACA provides subsidies for individuals with incomes between 133% and 400% of the Federal Poverty Level( FPL) and also cash allowances towards,deductible, copays,etc.which may be required by the various health insurance plans.

.Find out your tax credit from other information in this blog or Eric’s insurance web site

New details- employers-50-99 and over 100 employees!

The administration is giving certain employers extra time before they must offer health insurance to almost all their full-time workers.

Under new rules announced Monday by Treasury Department officials, employers with 50 to 99 workers will be given until 2016 — two years longer than originally envisioned under the Affordable Care Act — before they risk a federal penalty for not complying.

Companies with 100 workers or more are getting a different kind of one-year grace period. Instead of being required in 2015 to offer coverage to 95 percent of full-time workers, these bigger employers can avoid a fine by offering insurance to 70 percent of them next year.

By providing the dual phase-ins for employers of different sizes, administration officials have sought to lighten the burden on the small share of affected employers that have not offered insurance in the past.

Originally, the employer mandate — which affects companies employing 72 percent of all Americans — was to have gone into effect Jan. 1, at the same time the law began requiring most Americans to have health insurance.

The law says that anyone who works 30 hours or more is a full-time employee, and it compels many employers to offer affordable insurance to those workers and their dependents. It defines affordable as premiums of no more than 9.5 percent of an employee’s income, and employers must pay for the equivalent of 60 percent of the actuarial value of a worker’s coverage. Businesses that fail to do so will eventually face a fine of up to $2,000 for each employee not offered coverage, though workers are not required to sign up for the benefits.

Under the health-care law, small employers — those with fewer than 50 workers — do not have to offer insurance.

Administration officials said Monday that they will issue a separate set of rules in coming weeks that will cover related questions about how employers must report their workers’ insurance status to the government.

Some details in the new rule pleased fire companies, which had feared that the government might have required them to offer insurance to volunteer firefighters and other first responders. The rule also said that educators who have summers off are nonetheless to be treated as full-time workers entitled to be offered coverage. Adjunct faculty members will be counted as working 2.25 hours for ever hour in the classroom. And the rule said that seasonal workers — such as farm workers or extra department-store hires around Christmastime — are considered full time only if they work for at least half the year.

Looking for health insurance – with or without tax credits ( On or Off the exchange) go to:-

Eric’s insurance web site

Mid-size employers-50-99- insurance mandate delayed!

The administration says it will let employers with 50 to 99 full-time employees
wait until Jan. 1, 2016, to comply with the Patient Protection and Affordable Care Act (PPACA) group coverage mandate.

But employers with 100 or more full-time employers will have to comply with the Internal Revenue Code Section 4980H “play or pay” provision Jan. 1, 2015.

Employers affected by the requirements in 2015 would have to offer coverage to just 70 percent of full-time workers in the first year and 95 percent in the second year, according to new final regulations that are set to appear in the Federal Register Wednesday.

Midsize employers that want to wait until 2016 to comply cannot simply downsize to fit into the 50-99 FTE category, but employers close to the 100-employee cut-off may be able to qualify for the mandate delay if they can show they reduced workforce size or hours for “bona fide business reasons.”

Under PPACA, workers are “full-time employees” and eligible for the mandated coverage if they work more than 30 hours per week.

The regulations — Shared Responsibility for Employers Regarding Health Coverage (RIN 1545-BL33) — implement a tax law added by PPACA Section 1513.

Under PPACA, only workers who are not offered group health coverage are eligible to apply for exchange coverage subsidies.

Eric’s insurance website