ACA, ObamaCare compliance for companies offering Employee Benefits, or not

The ACA is very clear about companies with over 50 employees.  You better be offering Group Health Insurance, and it needs to be “affordable” by #ObamaCare standards.  The companies not complying in 2015 are just now feeling the wrath of the #ACA penalties in 2018.  Larger employers are getting hefty penalties for not complying.  I spoke to several larger employers back in 2014 that felt they did not have to comply and that the ACA was going to go away.  That didn’t happen.  Most of them felt that they didn’t want the government to tell them what to do.  All of the ones I spoke to, offered Employee Benefits, including Group Health Insurance.  They were out of compliance with the offering because their employees were made to pay more than 9.5% of their gross income.

ACA Affordability is measured in several ways

Most of our employers use the 9.5% standard.  One of the easier ways to become compliant with the offering of Group Health Insurance to an employee is to use their W-2 gross wages as a guide.  Using their wages, employees cannot be made to spend more than 9.5% of their wages on the Group Health Insurance offered by the company.  The business has to pick up the difference between the 9.5% and the cost of the coverage.  #GroupHealth coverage has to meet the minimum standards as well, with maternity, prescription drugs, and pediatric dental coverage.

The affordability is measured by the lowest cost plan offered to the employee

Because the 9.5% calculation is based on the price of the cheapest Group Health Plan offered to the employee, there was a rush to find the cheapest plan on the #GroupBenefits market that was compliant and available.  Depending on the year, that could be an #Aetna plan, or an #AnthemBlueCross plan.  #Kaiser has an inexpensive plan, but usually the skinny network PPO plans have Kaiser beat on lowest price.

All of the ACA compliance pieces are complicated and require some expertise.  Find yourself a Specialist, not a Generalist, when it comes to #EmployeeBenefits.  You’ll end up paying way less for the insurance and it will fit exactly what you need.  Too many times I run across a larger company that THINKS they are saving money, and they have a broker that does not specialize in Group Health or tries to be a “jack of all trades”.  Do yourself a favor and find an expert.

Brauer Insurance is an Independent Insurance brokerage that specializes in the dysfunctional, ridiculous and super expensive ACA, Group Health Insurance and Employee Benefits.  Call us, even if its for some advice!

Steve Brauer, Principal,  Brauer Insurance Services LLC……       To Protect and To Serve

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