PAGE 9
howcompetitive theHealth InsuranceMarketplacewill be, tax credits coupledwith
theoptions in theHealth InsuranceMarketplacemay help your business toprovide
cost-effectiveworkplacebenefits.
6
Formore informationabout small business tax credit
eligibility see
.
Firm size: Aqualifyingemployermust have25or fewer full-timeequivalent (FTE) workers. Employerswith
more than24workersmaybeeligible if they still have fewer than24FTEs. For example, if a firmhas40
employeeswhoworkpart-time, the firmmay count 20as FTEs and, therefore, the firmwouldqualify in this
group. Note: ThePPACA says that employerswith25or fewer FTEsmayqualify for thecredit; thecredit
amount isphaseddown to zero for anemployerwith25FTEs. The IRSwebsite, asof Sept. 20, 2013, says
that employerswith fewer than25FTEs areeligible for thecredit. Formore information, see
.
Penalties:
Employerswith at least 50 full-time equivalentsmust offer affordable,
minimum value health coverage to their full-time employees or face a penalty.
3.5
In
some cases, itmay be cost-effective for employees topurchase coverage through the
Health InsuranceMarketplace, despite the employer’s responsibility topay a penalty.
Discuss the strategy that is right for your businesswith your broker or benefits
advisor. Formore information about penalties by business size and coverage, see
TheHealth InsuranceMarketplacewill offer four levelsof coverage,which varydependingon
theproportionofmedical expenses the insuranceplan isexpected tocover.Of theseplans, a
“silver” plan (one that paysapproximately70percent ofmedical expensesor actuarial value) will
be thebenchmark for calculating subsidies. Individualscan “buy-up” toother plan levels, aswell
asadddental coverage. Additionally, they canpurchase voluntary insuranceoutsideof theHealth
InsuranceMarketplace.
9
PlanTiers:
9
•
Bronze:
plan pays approximately 60percent of coveredmedical expenses
•
Silver:
plan pays approximately 70percent of coveredmedical expenses
•
Gold:
plan pays approximately 80percent of coveredmedical expenses
•
Platinum:
plan pays approximately 90percent of coveredmedical expenses
Health insurance reforms and theHealth InsuranceMarketplacewill provide employeeswith
the option topurchase insurance directly from the individual market, so individualswill need to
better understandboth their options and health risks.While theACA requires businesses to
communicate to employees about theHealth Insurance
Marketplace andpotential eligibility for tax subsidies,
employeeswill be responsible for deciding how they
spend their health care dollars. As some employers
move towarddefined contribution plans, employees
will be in control of how they use and add to their
employer’s contribution.
Important Fact 5:
“Silver”or 70/30
coveragewill be
theMarketplace
benchmark.
Important Fact 6:
Marketplaces
affirm the
importance
of employee
education.
40
%
of employees say they
donot trulyunderstand
their employer’s
contribution to their
insurancebenefits.
2
