Insurance News

  • HHS Increases Civil Penalties for HIPAA Violations January 21, 2020
    Privacy and Security Rule Violations Impacted by Rule On Jan. 17, 2020, the Department of Health and Human Services (HHS) published a final rule increasing the civil monetary penalties for violations of the HIPAA Privacy and Security Rules. HHS is
  • DOL Increases Penalties for Group Health Plan Violations January 15, 2020
    2020 DOL Penalty Amounts for ERISA Violations Issued The U.S. Department of Labor (DOL) has increased the penalties employers face under ERISA for group health plan reporting and disclosure failures. These new amounts apply to penalties assessed after Jan. 15,
  • DOL Adopts New Joint Employer Determination Test January 14, 2020
    On Jan. 12, 2020, the U.S. Department of Labor (DOL) announced a new four factor balancing test to determine whether two or more organizations should be considered “joint employers” under the Fair Labor Standards Act (FLSA). The final rule establishing
  • DOL Publishes Guidance on Lump Sum Bonuses and Per-Project Payments January 10, 2020
    Opinion Letters Provide an Insight on How the DOL applies the Law to Specific Facts On Jan. 7, 2020 the U.S. Department of Labor (DOL) issued two opinion letters that clarify how the Fair Labor Standards Act (FLSA) applies in
  • New York Eliminates Tipped Employee Minimum Wage in Miscellaneous Industries January 10, 2020
    New Rate will Phase in Beginning June 30 On Dec. 31, 2019, New York amended its wage order for miscellaneous industries to eliminate the subminimum wage for tipped employees. Please note that the current tipped employee minimum wage rates still
  • Temporary Injunction on California AB 5 for Trucking Industry January 7, 2020
    Temporary Injunction Applies Only to the Trucking Industry A district court in San Diego has issued a temporary injunction to prevent enforcement of California’s recent AB 5 law for the trucking industry. This injunction does not affect other industries and
  • IRS Announces 2020 Standard Mileage Rates December 31, 2019
    On Dec. 31. 2019, the Internal Revenue Service (IRS) issued the 2020 optional standard mileage rates, which are used to calculate the deductible costs of operating an automobile for business, charitable, medical or moving purposes.
  • Washington Increases Threshold for Overtime Exemptions December 17, 2019
    New Law Becomes Effective July 1, 2020 On Dec. 11, 2019, Washington amended its wage and hour laws to increase the salary threshold white collar employees must satisfy to qualify for the state’s overtime exemption. The amendments also update some
  • Pennsylvania Extends E-Verify Requirement to Construction Industry December 17, 2019
    New Law Takes Effect Oct. 7, 2020 A new law in Pennsylvania law will require employers in the construction industry to use the federal E Verify system to confirm the employment eligibility of new hires. E Verify is a federal
  • DOL Issues 2020 Form W-4 December 13, 2019
    Employers Must Begin Using the New Form Jan. 1 On Dec. 5, 2019, the Internal Revenue Service released an updated version of its W 4 form, also known as the “Employee’s Withholding Certificate.”  Employers use IRS

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