Insurance News

  • DOL Publishes Guidance on $15 Minimum Wage for Federal Contractor Employees January 17, 2022
    Federal Contractors Can Use New Guidance To Understand and Implement EO 14026 On Jan. 13, 2022, the U.S. Department of Labor (DOL) published Field Assistance Bulletin (FAB) 2022 1 to help federal contractors understand and implement a $15 minimum wage
  • Supreme Court Stays OSHA ETS Vaccination and Testing Mandate January 14, 2022
    Employers Are Not Required to Comply with the Vaccination or Testing Mandate At This Time On Jan. 13, 2022, the Supreme Court of the United States (SCOTUS) ruled to stay the Occupational Safety and Health Administration’s (OSHA) vaccination and testing
  • Supreme Court Reinstates Vaccine Requirement for Health Care Workers January 14, 2022
    CMS Likely Will Resume Enforcement of the Emergency Rule  On Jan. 13, 2022, the U.S. Supreme Court dissolved the temporary injunctions blocking enforcement of the Centers for Medicare & Medicaid Services (CMS) emergency rule requiring COVID 19 vaccination of certain
  • Agencies Issue Guidance on Coverage of OTC COVID-19 Tests January 10, 2022
    Coverage of OCT COVID 19 Test To Be Covered Without Health Care Provided Involvement On Jan. 10, 2022, the Depts. of Labor, Health and Human Services (HHS), and the Treasury issued FAQ guidance regarding the requirements for group health plans
  • CDC Recommends Shorter COVID-19 Isolation and Quarantine December 30, 2021
    Asymptomatic Individuals Must Now Isolate For Five Days  On Monday, Dec. 27, 2021, the Centers for Disease Control and Prevention (CDC) reduced its recommended periods for COVID 19 isolation (confirmed COVID 19 infection) and quarantine (potential COVID
  • New York Adopts Final Regulations for Paid Sick Leave December 29, 2021
    The New York State Department of Labor has adopted final regulations for the state’s paid sick leave law. The regulations are unchanged from the Dec. 9, 2020, proposed regulations and cover the topics of definitions, documentation, employee count and accruals.
  • NYC Employers Must Allow Leave for Child COVID-19 Vaccinations December 28, 2021
    New York City has enacted a law requiring employers to provide paid leave for employees to accompany their children to COVID-19 vaccination appointments and care for them during vaccine recovery.
  • Supreme Court to Hold Hearings on Federal Vaccine Mandates December 24, 2021
    OSHA Will Delay Enforcement Until January 10 On Dec. 22, 2021, the U.S. Supreme Court announced that it will hear oral arguments regarding whether two federal vaccine requirements can be enforced while legal appeals are in process. On Jan. 7,
  • Court Reinstates OSHA Vaccination Mandate for Private Employers December 19, 2021
    The Reinstatement Allows OSHA To Implement And Enforce Compliance With The ETS Nationwide  On Friday Dec. 17, 2021 the 6th Circuit Federal Court of Appeals reinstated the Occupational Safety and Health Administration’s (OSHA) federal emergency temporary standard (ETS) for COVID
  • IRS Announces 2022 Standard Mileage Rates December 17, 2021
    On Dec. 17, 2021, the IRS issued the 2022 optional standard mileage rates, which are used to calculate the deductible costs of operating an automobile for business, charitable, medical or moving purposes.

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