Insurance News

  • NY Order and Guidance Affect COVID-19 Leave for Employees July 7, 2020
    New York Governor Andrew Cuomo has issued an order barring state COVID-19 leave for employees who travel to states on New York’s travel advisory. In addition, recent state guidance clarifies when health care workers under isolation or quarantine orders are eligible for leave under the New York law.
  • Colorado Passes Paid Sick Leave Law July 2, 2020
    The Colorado legislature has passed the Healthy Families and Workplaces Act (Act), requiring all Colorado employers to provide employees with different types of paid sick leave in different circumstances:
  • IRS Issues Guidance on Leave Donation Programs for COVID-19 June 30, 2020
    Employee leave donated to COVID-19 charities through employer-based programs will not be taxed as income of the donor employees, according to recent guidance by the IRS.
  • IRS Issues Proposed Regulations for Qualified Employee Transportation Fringe Benefits June 30, 2020
    The IRS has issued proposed regulations that provide guidance for employers determining the amount of nondeductible qualified fringe transportation expenses. The proposed rules also provide guidance for applying exceptions, and include definitions, special rules and methodologies.
  • DOL Issues Guidance on FFCRA Leave for Summer Camp Closures June 26, 2020
    The U.S. Department of Labor has issued Field Assistance Bulletin 2020-4, clarifying when employees may take paid leave under the Families First Coronavirus Response Act for the COVID-19-related closure of a summer camp, summer enrichment program or other summer program.
  • DOL Launches Employee Tool for Determining FFCRA Leave June 25, 2020
    The U.S. Department of Labor has created an online tool to help workers determine whether they qualify for paid leave under the Families First Coronavirus Response Act.
  • DOL Issues Five New Fair Labor Standards Act Opinion Letters June 25, 2020
    The New Letters Clarify Compliance Issues With the FLSA On June 25, 2020 the U.S. Department of Labor (DOL) published five new opinion letters. Opinion letters provide the DOL’s official position on how labor and employment standards apply in specific
  • Federal Agencies Release More FAQs on Coronavirus-related Changes for Health Plans June 25, 2020
    New FAQs Address a Variety of Health Coverage Issues Related to the COVID 19 Outbreak The Departments of Labor, Health and Human Services and the Treasury have provided answers to a second set of FAQs (FAQs Part 43) about health
  • President Trump Suspends Entry of Certain Foreign Workers June 25, 2020
    The Order Is Effective Between June 24 and December 31 On June 22, 2020, President Trump suspended the entry to the United States of certain foreign nationals holding specific working, nonimmigrant visas. The order becomes effective June 24, 2020 and
  • OSHA Issues Guidance for Reopening Nonessential Businesses June 22, 2020
    OSHA's Publication Includes Charts and Examples Help Implement Safety Principles On June 18, 2020, the Occupational Safety and Health Administration (OSHA) released guidance to help employers plan how to reopen nonessential businesses. The guidance also addresses issues employers should consider

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