Health Care Reform – Navigating the Affordable Care Act
The details and fine print of the health care reform initiative will make your head spin. Below are highlights, important dates and must-know information to jump-start your learning and compliance to the Affordable Care Act (ACT).
The Biggest Change
Beginning January 1, 2014, individuals and employees of small businesses will have access to affordable coverage through a new private health insurance market – the Health Insurance Marketplace. The Marketplace offers “one-stop shopping” to find and compare private health insurance options. Open enrollment for health insurance coverage through the Marketplace begins October 1, 2013 with coverage starting as soon as January 1, 2014. The Marketplace in Colorado is called Connect for Health Colorado. Here is a short video on what they offer.
What does this mean for INDIVIDUALS AND FAMILIES?
The changes are pretty simple for individuals and families. You are able to shop via the Health Insurance Marketplace and thus may save money on your plans. Find out more.
Also, starting in 2014 you can be assessed a fee if you are not insured with at least minimal essential coverage. This fee is 1% of your annual income or $95 per person for the year, whichever is higher. The fee increases in 2016 to 2.5% of income or $695 per person, whichever is higher. Children are additional. Find out more about uninsured fees.
What does this mean for SMALL BUSINESSES? (under 50 employees)
There are many implications for small business. First and foremost you do not have to offer insurance to your employees. If you do, you can use the Small Business Health Options Program (SHOP) which is part of the new marketplace or portal mentioned above.
Starting in 2014, if you have fewer than 25 full-time employees making an average of $50,000 a year or less, you could get up to 50% of your employee premium contribution back. Find out more about tax credits.
What does this mean for LARGE BUSINESSES? (over 50 employees)
The Affordable Care Act will not provide Marketplace or SHOP access to larger companies until 2016 when they open the portal to companies with 100 or less full-time employees.
Starting in 2015, large companies will be subject to the Employer Shared Responsibility Payment. Organizations have to offer employees coverage whose premiums are no greater than 9.5% of annual household income (for self coverage) and the health plan pays for at least 60% of expenses for the average population. If this is not the case, employees can get more cost efficient coverage via the Marketplace and thus the employer will be penalized.
One way to avoid this payment is to have less than 50 full-time employees. Many companies are choosing to utilize personnel services for sub-contractors so they don’t assume the responsibility of the “employer of record” and thus the insurance coverage or penalty payments.
Learn more about how employers must notify their employees of the Marketplace and potential cost savings, health care reporting and disclosure requirements, and more.
Get help navigating the ACT
Thanks to a grant from the Connect for Health Colorado – Eagle, Pitkin and Garfield counties will have a Health Coverage Guide to help navigate the system and find the right coverage for employees and individuals. They will help compare the cost and quality of various plans, put together presentations for the Small Business and Individual Marketplaces, determine eligibility of tax credits and more. Feel free to contact Maria Vasquez, the Health Assistance Network Manager, at 970-328-8736, email@example.com
Important Dates: Affordable Care Act
October 1, 2013 – Employee must be notified of coverage options
- Guidelines for notices of coverage
- Templates for employee coverage notices (see bottom of page)
January 1, 2014 – Employers begin tracking “full-time” employees
January 1, 2015 – Affordable Care Act employer mandate goes into effect
For more information on Hot Jobs acting as the employee of record for personnel needs, please contact Kathryn Consoli, President/Owner of Hot Jobs Inc. 970-963-2647.