We've had many calls.
Business owners or HR managers lift up their head from an ever-increasing pile of work to find out.
They might know a little about item A....or a little about item B
But it's item C that's accruing a huge penalty.
And they won't find out till April.
Before you go back to that stack of work, let's lay out the most important ACA changes that all companies need to be aware of.
Here's the main list with more detail below:
The ACA law has affected the entire benefits market in ways unseen since AB1672 and guaranteed issue.
These are the big changes...there's lots of little ones we can't cover without writing a book.
Let's get into it!
This is the big one depending on your company size.
Let's first address the size issue since that has also changed
The new "Equivalent" calculation
We no longer look at "full time" employees only.
We look at the "equivalent" of full time employees.
To calculate your equivalent number, take the total # of payroll hours and divide by # of employees.
For example, 10 employees at 30 hours is the same as 20 employees at 15 hours.
They both equal 10 full time employees in the new "equivalent" calculation.
This important since most employers are use to thinking about full-time employees only.
Okay, now that we can figure out the correct equivalent, here's the rule.
You could have a 100 employees that each work 15 hours and still have to offer coverage.
Careful...there are many companies that are on the wrong side of this law.
There are actually two different penalties we need to compare.
Here are the options:
Which option makes the most sense depends on a few factors.
We can run the full comparison across all three options to see what the total cost and exposure is for each.
There's no cost for this service and we're happy to help at 866-486-6551
Get used to a metallic taste when comparing new health plans.
All the new ACA group health plans fall within four distinct categories.
New Metallic Plan Levels:
By law, a given plan can't differ from the baseline coverage by +/- 2%.
That means we have 4 very discreet levels of coverage now.
That being said, the carriers can add here and take away there. For example, the deductible may be lower than average but the copays are not as rich.
It does make it a little easier to compare based on core levels...i.e. a Bronze to a Bronze between two carriers.
The issue is that many of the old popular plans for companies combined high deductibles for the big bill and copays for the smaller bills. That's harder to come by now.
We can quickly quote your company at each benchmark across all the carriers so you can see where the best pricing is.
Starting Jan 1st, 2016, large group is now considered 100+ employees instead of 50%.
Large group has always been very different from small group in terms of plan options, pricing, and just general process.
For some companies adjusting to Small Group, it can be a big shock in terms of premium.
Combine this with the new ACA health plans mentioned above and it's a whole new world.
Here are the important concerns:
Most companies are being transitioned to Small Grouip at renewal.
It's important to run all the numbers a few months prior.
This is a big one.
Basically, in July of 2015, the IRS came out and ended the debate (but not the misinformation).
$36,500 penalty per employee each year!
The IRS is sending a huge signal to employers. Take heed.
So what are the options?
An employer can either offer a legitimate business health plan or the employees can take care of their own health coverage.
Do not mix the two!
Call 866-486-6551 if you need help with these options.
We touched on this above in the Penalty section.
Here's the math:
For example, 12 employees that work 10 hours will equal to 120 hours.
This is the equivalent of 4 full time employees (120/30).
Why does this matter?
Large changes of the new ACA law are based on this calculation such as:
Look-back period for the equivalent qualification
The law requires that employers look at the prior year's employment to determine their equivalent eligibility.
An employer can't just fire a bunch of people Dec 15th or move people to part-time in order to avoid the penalty for the following calendar year.
We can help you navigate this whole process at 866-486-6551 or by requesting a quote here.
This is a lot of money and only a small percentage of the eligible California companies are enrolled.
We're not talking small dollars or low eligibility.
Take a look:
If this might be your company, call us right way at 866-486-6551 or check the "Tax Credit" button when requesting quote here.
This is literally found money for 100's of 1000s of California companies from the IRS.
Never turn down money from the IRS!
Have you noticed all new requests from the IRS for payroll?
Did you burn them in celebratory gun-fire?
We don't recommend the latter.
There are new rules and requirements companies must follow to stay in the good graces of the IRS.
We've written a full article on the Business health insurance reporting requirements but here are the highlights:
Here are the important due dates:
Most reporting applies to employers that are subject to the employer mandate (50+ full time equivalents).
Get more detail on these forms and deadlines from our Employer health plan reporting article.
For most companies, the new reporting regime is probably the most confusing. Let us help you navigate this to protect your companies from pretty sizable penalties.
Call 866-486-6551 to discuss your requirements for Employer reporting.
In the past, some companies had difficulties enrolling in Employer based health plans due to eligibility requirements.
The key points of contention dealt with participation (% of eligible employees that enroll) and contribution (amount that employer paid towards employee's health plan).
Good news for these companies!
This works for many companies where employee have other coverage or don't enroll.
It can also relax the burden on employers that feel they can't afford to afford a group health plan.
Now you can!
The Special Enrollment period typically opens 12/1 of each year but we want to have everything ready before then.
Request your Business health quote (with a note on Eligibility concerns) here or call us at 866-486-6551 to see if this window might help you.
Okay, we've dealt with some of the specific rules and changes from the law.
Here are the market reactions as well:
These are a just sampling of the changes. Everything has changed!
The main item we want to impart on employers is this...
They're big and many employers are accruing them right now....and they don't need to.
Let us run quotes across all the different options to see if there's away to avoid penalty, offer affordable coverage, and survive the ACA transition.
Call us at 866-486-6551 or request your
Company Health Quote.
"a million thank you for your prompt attention to all the details concerning this process. You've made it that much easier to enroll."
"Thanks again for your help - I had absolutely no idea how to get this done when I got up this morning. You've made it remarkably easier than I expected. I hope you're not stuck at the office all night..."
"Anyway, I hope you got some time off this past week! Thank you again for your help and efforts on my behalf! I was very lucky to find you."
"I thank you very much for the time that you have invested in handling everything
"I truly appreciate the quick response and will think of you in the future if I need to make any changes to my insurance plans."
"You are awesome... takes a huge worry off my back, thank you for your kind. thanks for your time and kindness. !!"
"Wow, I can't thank you guys enough for your help...I couldn't imagine trying to tackle this on my own!"
"You are my new best friend. A HUGE thank you again.
Group health insurance requires a constant discipline to make sure your company has the best value on the market. Expert and Impartial advisors dedicated to this endeavor is Invaluable
We are Certified Covered California Small Business Agents and Licensed California Group Health Agents with 20+ years of experience helping 1000's of California companies.
Call me. you will be pleasantly surprised 866-486-6551
We'll quickly see if you have the best priced plan available and if you qualify for a tax credit866-486-6551