The Coronavirus pandemic has had a massive impact on the financial health of thousands of companies in the United States. These employers have seen the enormous reduction in business and the effect it has on their employee benefit programs, and adjust them to meet the needs of both their employees and their business. These adjustments still carry certain obligations the employer must meet under federal legislation. So what do employers need to know about FFRCA and benefits?
https://www.sbmabenefits.com/wp-content/uploads/2020/07/job-applicant-passing-her-documents-3760072-1-scaled.jpg17072560Amanda Rogershttps://www.sbmabenefits.com/wp-content/uploads/2021/12/SBMA_Website-Logo_250x150.pngAmanda Rogers2020-07-21 14:03:142024-02-16 11:35:33What Employers Need to Know About FFRCA and Benefits
All applicable large employers (ALEs) must comply with the Affordable Care Act (ACA), which requires employers to offer minimum essential coverage to all employees.
If an employer does not comply with this employee coverage requirement, it could lead to penalties for the employer and potentially an IRS audit.
Below is a breakdown of ACA penalties A and B and how they could affect your company.
Who is Considered a Large Employer?
First, who is considered a large employer?
Any company or organization with an average of at least 50 full-time employees or “full-time equivalents (FTEs) is considered an applicable large employer.
*For the purposes of the ACA, a full-time employee is someone who works a minimum of 30 hours a week.
Pregnancy, maternity, and newborn care (before and after birth)
Mental health and substance use disorder services
Prescription drugs
Rehabilitative and habilitative services and devices
Laboratory services
Preventative and wellness services and chronic disease management
Pediatric services”
Additionally, ACA benefits cover birth control and breastfeeding support.
The Employer Mandate (Penalty A)
Employers must offer at least Minimum Essential Coverage (MEC) to any benefit-eligible employee. Non-compliance will generally result in a penalty of $2,750 annually PER eligible employee.
The Employer Mandate (Penalty B)
Employers must offer a minimum value plan that meets 60% actuarial value, including hospitalization services.
The MV plan must be offered at a maximum contribution of 9.86% of the employee’s income – YOU pay the difference.
For example, take a California minimum wage employee: A $10.00/hour employee working a minimum of 30 hours per week has a maximum employee contribution of $128.18 per month.
If the plan cost is $300, YOU pay the difference of $171.82 per month.
Non-compliance will generally result in an annual $4,120.00 penalty PER employee who enrolls in coverage through the state exchange AND receives a premium subsidy.
The Individual Mandate
The individual mandate went away starting January 1st, 2019, for most Americans.
Those individuals in specific states that maintain the individual mandate, including the District of Columbia, Massachusetts, or New Jersey, will continue to be penalized according to the individual mandate.
These penalties can easily add up with over 100 employees eligible for health coverage. At SBMA, we want to help you avoid any potential penalties for lack of proper insurance.
https://www.sbmabenefits.com/wp-content/uploads/2020/07/ACA-Penalty-A-and-B-Breakdown.png6281200Amanda Rogershttps://www.sbmabenefits.com/wp-content/uploads/2021/12/SBMA_Website-Logo_250x150.pngAmanda Rogers2020-07-21 13:35:502022-08-28 22:12:17ACA Penalty A and B Breakdown
Under the Affordable Care Act (ACA), large employers are required to offer health insurance to their employees. Despite everything going on, the IRS will continue issuing letters to large employers regarding penalties for years prior. Beginning in 2015, employers that do not meet the ACA standards can be assessed by a shared responsibility payment. Here are a few of the details behind the ACA health plan penalties and what that may mean for your business:
https://www.sbmabenefits.com/wp-content/uploads/2020/07/Screen-Shot-2020-07-21-at-11.34.32-AM.png7111071Amanda Rogershttps://www.sbmabenefits.com/wp-content/uploads/2021/12/SBMA_Website-Logo_250x150.pngAmanda Rogers2020-07-21 11:35:532021-11-29 15:37:46ACA Penalties May Affect Your Business
Having coverage is extremely important in ensuring your health and wellbeing especially during today’s environment. While some states believe that it’s too late to expand Medicaid coverage, it could help those unemployed greatly. Over the last few months, all but 15 states have participated in the expansion of Medicaid. This coverage can help save lives.
https://www.sbmabenefits.com/wp-content/uploads/2020/07/Screen-Shot-2020-07-21-at-10.24.08-AM.png7081074Amanda Rogershttps://www.sbmabenefits.com/wp-content/uploads/2021/12/SBMA_Website-Logo_250x150.pngAmanda Rogers2020-07-21 10:26:162021-11-29 15:35:32Medicaid Coverage Can Save Lives!
With the recent pandemic, many things have changed in regard to healthcare services. One major way healthcare has changed over the last few months is through the expansion of telehealth services. The Office of Civil Rights has recently relaxed the constraints surrounding which video conferencing applications are HIPAA compliant provided that these services are provided in good faith. As OCR relaxed HIPAA enforcement, there have been increases in telehealth services. The article below details how these relaxed regulations have changed the telemedicine world, and why we can expect it to stick post-COVID:
https://www.sbmabenefits.com/wp-content/uploads/2020/07/Screen-Shot-2020-07-21-at-10.04.24-AM.png711475Amanda Rogershttps://www.sbmabenefits.com/wp-content/uploads/2021/12/SBMA_Website-Logo_250x150.pngAmanda Rogers2020-07-21 10:15:272021-11-29 15:34:43Relaxed HIPAA Enforcement Paves The Way For Increase In Telehealth Services
Due to COVID-19, ACA compliance has become a bit more complicated. As an employer, you must ensure that all your paperwork and practices are ACA compliant. If individuals wrongly receive a PTC, the employer is responsible for proving to the IRS that the individual did not qualify. It is now more important than ever to have your information in order, in case of future issues. In the ACA times article below, you will see why ACA penalties may increase this year, and how you can prevent potential penalties for your business.
https://www.sbmabenefits.com/wp-content/uploads/2020/07/Screen-Shot-2020-07-20-at-6.26.12-PM.png7121076Amanda Rogershttps://www.sbmabenefits.com/wp-content/uploads/2021/12/SBMA_Website-Logo_250x150.pngAmanda Rogers2020-07-20 18:28:492024-02-16 09:44:22How to Prevent ACA Penalties due to COVID-19
Under the CARES Act, the Secretary of the Department of Health and Human Services was instructed to write payments under the Inpatient Prospective Payment System by 20% for Medicare beneficiaries who have had COVID-19.
Throughout 2020 we have seen a lot of changes in the workforce. This causes a lot of confusion surrounding ACA reporting for those with 50 or more full-time employees.
https://www.sbmabenefits.com/wp-content/uploads/2020/07/the-climate-reality-project-Hb6uWq0i4MI-unsplash-1-scaled.jpg17072560Amanda Rogershttps://www.sbmabenefits.com/wp-content/uploads/2021/12/SBMA_Website-Logo_250x150.pngAmanda Rogers2020-07-20 12:51:162021-11-29 15:31:53What You Need to Know About 2020 ACA Reporting
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