Insurance News

  • DOL Releases Updated Model Employer CHIP Notice August 7, 2018
    The U.S. Department of Labor (DOL) has updated its model notice for employers to provide information on eligibility for premium assistance under Medicaid or the Children's Health Insurance Program (CHIP). This notice is generally updated twice a year.
  • New Expiration Date for Certain Model FMLA Notices is Aug. 31 August 2, 2018
    The U.S. Department of Labor's Wage and Hour Division (WHD) has extended the effective date for some of its model FMLA notices through August 31, 2018.
  • Protect Your Business Against Spear-Phishing Emails July 26, 2018
    Cyberattacks and resulting data breaches often begin with a spear-phishing email. Spear phishing differs from regular email phishing in its use of extensive research to target a specific audience, which allows the spear phisher to pose as a familiar and trusted entity in its email to a mark. Read this newsfeed update to learn tops to protect your business ag […]
  • South Carolina Updates Employment Discrimination Poster July 24, 2018
    South Carolina has updated its employment discrimination poster to include required language regarding pregnancy accommodations.
  • Delaware Adjusts Minimum Wage Increase Effective Date July 19, 2018
    Delaware has adjusted its minimum wage increase to $8.75 per hour to take effect on January 1, 2019.
  • Summary Annual Reports Due Sept. 30 July 18, 2018
    Health plans with 100 or more plan participants at the beginning of a plan year are generally required to furnish a Summary Annual Report (SAR) to each health plan participant within 9 months after the end of a plan year. As a result, the deadline for most calendar year plans to satisfy the SAR requirement for plan year 2017 is September 30, 2018.
  • Delaware Raises Minimum Wage July 16, 2018
    Under a new law, Delaware’s minimum wage will increase to:
  • Oklahoma Passes Medical Marijuana Law July 12, 2018
    Effective July 26, 2018, Oklahoma law will generally prohibit employers from discriminating against a medical marijuana patient in hiring, termination, or any term or condition of employment.
  • Court Strikes Down Parts of CA Immigration Law July 11, 2018
    As a result of a recent federal district court ruling, California employers are no longer prohibited from:
  • New Expiration Date for Certain FMLA Notices is July 31, 2018 July 9, 2018
    The U.S. Department of Labor's Wage and Hour Division (WHD) has extended the effective date of several model FMLA notices through July 31, 2018.

Employers have much to think about nowadays in addition to running their businesses. While Health Care Reform (PPACA) passed in 2010, to add to the confusion many of the changes the law created have been delayed or amended. Employers who fall under the mandate will have new reporting requirements and potential penalties. Small employers may consider the benefits of purchasing in the SHOP exchange where they may qualify for the small business tax credit or disbanding their group plan and having employees purchase individual coverage potentially getting subsidies for premium and cost sharing expenses. Glandon Insurance can help you with exploring your options, keeping you in compliance or when considering self insurance.

Pay or Play (Employer Shared Responsibility)

The employer shared responsibility provisions (also known as “pay or play”) require large employers—generally those with at least 50 full-time employees, including full-time equivalent employees (FTEs)—to offer affordable health insurance that provides a minimum level of coverage to full-time employees (and their dependents) or pay a penalty tax if any full-time employee is certified to receive a premium tax credit for purchasing individual coverage on the Health Insurance Marketplace (Exchange).

The “pay or play” requirements are delayed until 2016 for employers with 50 to 99 full-time employees who certify that they meet certain eligibility criteria related to workforce size, maintenance of workforce and overall hours of service, and maintenance of previously offered health coverage.

 Employer Liability for the Pay or Play Penalty

For 2016 (and, if applicable for employers with non-calendar year plans, any calendar months during the 2016 plan year that fall in 2017), an employer who is subject to the “pay or play” requirements will be liable for a penalty only if:

  • The employer does not offer health coverage or offers coverage to fewer than 70% of its full-time employees (and their dependents, unless transition relief applies), and at least one full-time employee receives a premium tax credit; or
  • The employer offers health coverage to at least 70% of its full-time employees (and their dependents, unless transition relief applies), but at least one full-time employee receives a premium tax credit, which may occur because the employer did not offer coverage to that employee or because the coverage the employer offered that employee was either unaffordable to the employee or did not provide minimum value.

After 2016, 95% should be substituted for 70% in the bullets above.

Small Business Health Care Tax Credit

Certain small businesses and tax-exempt employers that pay at least half of the premiums for employee health insurance coverage may be eligible for the small businesses health care tax credit. For tax years 2010–2013, the maximum credit is 35% for small business employers and 25% for small tax-exempt employers. For tax years beginning in 2014 or later, the maximum credit increases to 50% of premiums paid for small businesses and 35% of premiums paid for small tax-exempt employers.

For a quick look at the Small Business Tax Credit and eligibility:

Small Business Tax Credit Calculator