Your Health Care Reform Questions Answered

Revealing What Employers Want to Know

The Patient Protection and Affordable Care Act, commonly known as health care reform, remains a work in progress. Changes to the requirements can bring uncertainty and questions. We've outlined and answered the most common questions from employers like you surrounding health care reform.

Who am I required to cover?

  • Full-Time Employees (FTEs) working at least 30 hours of service each week, as well as their dependent children under the age of 26.1

Does my company need to comply?

  • If you have 100+ employees, you must comply in 2015.
  • If you have 50-100 employees, you must comply in 2016.
  • If you have less than 50 employees, you do not need to comply.

What are the potential penalties?

  • $2,000 per FTEs if an employer doesn’t offer any type of health care coverage to substantially all of its FTEs and their dependents.
  • $3,000 per FTEs if an employer offers coverage that's either unaffordable or doesn't meet minimum value requirements.

What's the new waiting period limit?

  • Health care reform restricts waiting periods to a max of 90 days for group health plans and group health insurers.2

How can I receive Tax Benefits?

  • If you have fewer than 25 employees paying average annual wages of less than $50,000 and provide health insurance may qualify for a tax credit of 35-50% of their contributions to insurance premiums.3

What are workplace wellness programs?

  • Programs and other activities to support healthier workplaces. The maximum reward to employers using a wellness program that’s contingent on employee health has increased from 20%-30% of the cost of health coverage.4

How can I be eligible for the small employer health insurance credit?

  • Have fewer than 25 FTEs for the taxable year.
  • Have average annual employee wages that amount to less than $50,800 per FTE.
  • Maintain a “qualifying arrangement” in which the employer pays premiums for each employee enrolled in health insurance offered by the employer.
  • The plan must be offered through a SHOP.5

Offer Voluntary Benefits. Give your employees financial security at little to no cost to you.



1Internal Revenue Service (2014). Questions and Answers on Employer Shared Responsibility Provisions Under the Affordable Care Act, accessed on June 3, 2015 from http://www.irs.gov/Affordable-Care-Act/Employers/Questions-and-Answers-on-Employer-Shared-Responsibility-Provisions-Under-the-Affordable-Care-Act.
2U.S. Department of Labor (2012). Frequently Asked Questions from Employers Regarding Automatic Enrollment, Employer Shared Responsibility, and Waiting Periods, accessed June 1, 2015 from dol.gov/ebsa/newsroom/tr12-01.html.
3U.S. Department of Health & Human Services (2014). Small Business Tax Credits, accessed June 2, 2015 from http://www.hhs.gov/healthcare/insurance/employers/index.html.
4HealthCare.gov (2015). Other information about the health care law for small businesses, accessed on June 4, 2015 from https://www.healthcare.gov/small-businesses/other-aca-information-for-business/.
5HealthCare.gov (2015). Small Business Health Care Tax Credits, accessed on June 4, 2015 from https://www.healthcare.gov/small-businesses/provide-shop-coverage/small-business-tax-credits/.