Running a business like or is about to get more complicated. There are still a lot of unknowns when it comes to the Affordable Care Act (also known as ACA or Obamacare), but there is general consensus that it will have a big impact on businesses.
Starting in 2015, businesses with 50 or more full-time employees will face fines if they don鈥檛 provide affordable health insurance for workers. We spoke with , a senior consultant at Alkali Benefits in Plano, to find out more.
Large employers (50 or more employees) will be required to provide both 鈥渁dequate鈥� and 鈥渁ffordable鈥� coverage.
Coverage is considered 鈥�,鈥� Gaines says, if the employer covers at least 60 percent of the 鈥渢otal employee-only plan cost,鈥� which includes premiums, deductibles, co-insurance and co-pays.
Coverage is considered 鈥渁ffordable鈥� if the employee doesn鈥檛 have to pay more than 9.5 percent of his or her modified adjusted gross household income.
Large employers will have three ways to meet the requirement of providing 鈥渁dequate鈥� and 鈥渁ffordable鈥� coverage.
- They can customize their plans.
- They can pick a on the marketplace designed to pay a minimum of 60 percent of the total employee plan cost. Employers, like individuals participating in the health marketplace, will be able to choose a level of coverage 鈥� from basic bronze to mid-level gold to full-blown platinum.
- They can give each employee money to buy insurance that鈥檚 the 鈥渂est fit.鈥� This is also known as the 鈥溾�� plan.
(Employers with fewer than 50 employees won鈥檛 have to provide health care, but the act gives them incentives to do that. For example, employers with no more than 25 employees, earning less than $50,000 on average, can take advantage of the .)
Each business will be affected differently.
Joyce Gaines sorts business into three categories:
- ACA 鈥渄isadvantaged鈥� 鈥� companies that have healthy, young, low-paid workers, such as restaurants and manufacturers, will take the hardest financial hit.
- ACA 鈥渁dvantaged鈥� 鈥� firms with older and sicker employees who use medical care a lot will get the best return on investment from the ACA.
- ACA 鈥淣eutral鈥� 鈥� larger companies with high-skill and high-wage jobs (e.g. law firms) that are already paying for robust benefits will not have drastic changes in their bottom line.
Employers (and employees) need to stay updated on changes in the ACA.
Gaines says employers need to find a competent health-care broker who is well-versed about the ACA and who provides updates as they unfold. In addition to getting information from their employers, employees can find useful tips on and the 鈥榮 website.
