Insurance News

  • DOL Provides Guidance on Small Employer Exemption to Coronavirus Paid Leave March 30, 2020
    New FAQs on the FFCRA Address Small Employer Exemption The U.S. Department of Labor (DOL) issued new FAQs that address the small employer exemption to certain paid leave requirements under the Families First Coronavirus Response Act (FFCRA).  Small
  • DOL Issues Guidance Documents on FFCRA March 27, 2020
    Guidance materials on the new Families First Coronavirus Response Act are now available for employers from the U.S. Department of Labor (DOL). Links to the materials, which explain how the law will be implemented and include required notices, can be found on a DOL webpage dedicated to COVID-19.
  • DOL: New Paid Leave Requirements Take Effect April 1 March 25, 2020
    Coronavirus Response Act Applies to Leaves Taken April – Dec. 2020 The paid leave provisions of the recently enacted Families First Coronavirus Response Act will go into effect April 1, 2020, according to Q&As released by the U.S. Department of
  • Congress Passes Coronavirus Aid Law March 18, 2020
    On March 18, 2020, President Trump signed into law a coronavirus relief bill, requiring employers to provide paid sick leave for reasons related to the pandemic, among other measures.
  • Health Plans Must Provide Free Coronavirus (COVID-19) Testing March 18, 2020
    Health Plans Must Cover COVID 19 Testing At No Charge On March 18, 2020, the U.S. Congress passed its second coronavirus relief measure – the Families First Coronavirus Response Act (Act). President Trump is expected to sign the bill into
  • House Approves Corrections to Coronavirus Relief Bill March 17, 2020
    On March 16, the U.S. House of Representatives passed technical corrections to the coronavirus relief bill, titled the Families First Coronavirus Response Act.
  • House of Representatives Passes Coronavirus Relief Bill March 16, 2020
    The U.S. House of Representatives passed the Families First Coronavirus Response Act on March 14, 2020, following negotiations with the White House. The U.S. Senate is expected to vote on the bill this week.
  • Deal Reached on Coronavirus Aid March 14, 2020
    The White House and U.S. House of Representatives have reached a deal that would involve several billion dollars in federal spending and provide free medical testing, paid leave, food assistance for poor families, and other aid for people affected by the coronavirus (COVID-19) outbreak.
  • CO Mandates Paid Employee Sick Days for COVID-19 Testing March 12, 2020
    Effective immediately, Colorado employers in seven industries must give employees up to four days of paid sick leave for testing coronavirus (COVID 19) testing.
  • California Labor Commissioner Issues Guidance on Coronavirus March 12, 2020
    The FAQs address issues such as leave for employees under quarantine or at risk of exposure, questioning employees about their travel to high-risk areas, and the effect of operational shutdowns on employee compensation.

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