Insurance News

  • Virginia Legalizes Marijuana and Expands Employer Restrictions February 23, 2021
    The New Law Affects Background Checks for Job Applicants On Feb. 5, 2021, Virginia passed a new law (House Bill 2312) that legalizes recreational marijuana for adults ages 21 and older in the state. The new law also expands an
  • DOL Proposes New Effective Date for Independent Contractor Rule February 23, 2021
    The Delay Would Allow the Biden Administration Time to Evaluate the Rule Before It Becomes Effective On Friday, Feb. 5, 2021, the U.S. Department of Labor’s (DOL) Wage and Hour Division (WHD) proposed delaying the effective date for the Independent
  • CDC Provides Guidance on Consent and Disclosures for Workplace COVID-19 Testing February 23, 2021
    Informed Consent Requires Disclosure, Understanding and Free Choice The Centers for Disease Control and Prevention (CDC) has issued guidance on the elements of consent and disclosures necessary to support employee decision making when employers incorporate workplace COVID 19 testing.
  • Outbreak Period Expiration Approaching February 22, 2021
    Last year, federal agencies issued relief postponing various employee benefit plan deadlines during a defined “Outbreak Period” to help plans, participants and service providers impacted by the COVID-19 pandemic.
  • 9th Cir.: FMLA Leave Includes “Off” Time in Rotating Schedules February 19, 2021
    An employee working a “one week on, one week off” schedule who takes 12 workweeks of continuous federal Family and Medical Leave Act (FMLA) leave may be required to return to work 12 weeks later, a federal appeals court has held.
  • Additional COVID-19 Relief and Clarifying Guidance for Cafeteria Plans February 18, 2021
    On Feb. 18, 2021, the IRS released Notice 2021-15, which provides additional mid-year election change relief for Section 125 cafeteria plans for plan years ending in 2021.
  • Employers May Have to Provide Paid Military Leave, Court Says February 17, 2021
    Employees who take off work for military duty may be entitled to paid leave from their employers, according to a Feb. 3, 2021, federal appeals court decision.
  • DOL Issues Updated Model Employer CHIP Notice February 9, 2021
    The Department of Labor (DOL) has released a new model Employer CHIP Notice with information current as of Jan. 31, 2021.
  • New York Issues New Guidance on COVID-19 Leave February 3, 2021
    Employers who prohibit employees not in quarantine or isolation from coming to work for COVID-19 exposure reasons must pay them their regular rate, according to new guidance issued by the New York Department of Labor. The Jan. 20, 2021, guidance also states that employees may take leave for three periods of quarantine or isolation, among other points.
  • IRS Updates FAQs on Employer Tax Credits for FFCRA Leave February 2, 2021
    On Jan. 29, 2021, the IRS updated its frequently asked questions on tax credits available to employers for providing paid employee leave under the Families First Coronavirus Response Act.

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