9 ACA Employer Mandate FAQs for Employers and their Brokers

 

The Affordable Care Act (ACA) is still in effect, despite efforts to dismantle it. This means its employer mandate is still in effect, and something employers and brokers can’t ignore. Plexus Technology Services, which delivers innovative technology reporting solutions to companies needing to report ACA information to the government, provides 9 ACA FAQs (frequently asked questions) about the employer mandate for employers and their brokers.

 

What is the ACA employer mandate?

Employers with 50 of more full-time employees must offer those workers and dependents the chance to enroll in minimum essential coverage under an employer-sponsored plan.

 

What is “full-time” under health care reform?

Working at least 30 hours per week or 130 hours in a calendar month. A special rule covers “seasonal workers” and others not continuously employed.

 

What is the look-back method for counting full-time employees?

Count the number of full-time employees during each calendar month and divide by 12.

 

What is an offer of health coverage?

Employees with 50 or more employees must offer coverage during a plan year. Employees must pay their share within 30 days of due date.

 

When is employer coverage considered unaffordable?

If the employee’s required contribution for self-only coverage exceeds 9.69 percent of their household income for the taxable year.

 

How are wellness programs treated?

If a wellness program provides medical benefits, it will likely be treated as a group health plan, subject to non-discrimination requirements.

 

How are stand-alone wellness programs treated?

If they don’t pay for medical benefits, they are not treated as group health plans.

 

Who handles the Summary of Benefits and Coverage?

The insurer prepares the SBC, and the plan sponsor distributes it. A self-funded plan prepares its own SBC.

 

What are the two employer mandate penalties?

No Minimum Essential Coverage: $2,260 per full-time employee.

Inadequate Health Plan: $3,390 per full-time employee.

 

Have questions regarding these ACA mandates and filing? Contact a Plexus Technology Services associate in Deer Park, Illinois at 847-307-6100, Chicago at 312-606-4800, Dallas at 972-770-5010 or Oklahoma City at 405-840-3033. We’re here to help and we’re happy to help.

Content provided by BenefitsPro.