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Many businesses may already offer benefits that meet or exceed federal standards, or can
meet the standards with minor adjustments. These companies may find they can capitalize on
going above and beyond to help protect workforce health and wellbeing.
Considerations
Coverage
• The employer provides minimum value coverage that meets affordability
requirements.
Compliance
• The employer will need to comply with all applicable federal and state laws and rules.
• The employer will need to comply with the new Affordable Care Act (ACA) benefit
mandates including metal levels and/or minimum value requirements.
• The employer needs to be aware of all the ACA compliance requirements, specifically
the benefit mandates, and grandfathering if applicable, that directly affect them.
• Employers must notify employees regarding the availability of the Health Insurance
Marketplace and subsidies that could help lower the cost of insurance coverage (by
October 1, 2013, and for all new employees at the time of employment).
Tax Credits
• The employer will not be eligible to receive small business tax credits.
• Employees may be eligible to receive Health Insurance Marketplace subsidies if their
employer’s coverage does not provide minimum value or affordability requirements.
Penalties
• Starting in 2015, employers with 100 or more full-time equivalent employees may
be subject to shared responsibility penalties if coverage either does not meet
affordability or minimum value requirements, and is offered to fewer than 70 percent
of its full-time employees and the dependents of those employees (unless the
employer qualifies for 2015 dependent coverage transition relief).
• In 2016, the 70 percent threshold is increased to 95 percent and the shared
responsibility penalties will also apply to employers with 50 or more full-time
equivalent employees.
Administration • The employer will continue to use their current practices to work with issuers to
obtain and maintain coverage.
• Starting in 2016, the employer will submit required reporting to the Internal Revenue
Service.
Employee
Tools and
Resources
• Employees will use current practices for open enrollment and select from health plan
choices that are made available by the employer.
• Employees may use a single seamless process to obtain a full benefits package
including voluntary benefits.
Supplemental
Insurance
Protection
• The employer can provide voluntary benefits to workers along with the current health
plan.
• These policies can be bought separately to help employees cover out-of-pocket
costs associated with illness or injury.
Adjust
Current Plan
