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Becker & Associates

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Comply Or Else!

Posted on July 7, 2015 at 6:10 PM

January 1st, 2016 is just around the corner with the "Employer Mandate" finally kicking in.

Employers with 50 or more Full Time employees must now offer mandated coverage to at least 95% of their employees and their children up to age 26.  "Mandated" coverage is coverage that provides minimum essential coverage and is affordable (affordable means employee cost cannot exceed 9.5% of their income).

Employers who do not offer coverage will be penalized to the tune of $2000. per full time employee (minus the first 30).  This penalty applies if just ONE full time employee receives federal premium subsidy for marketplace coverage.  Employers must treat all employees who average 30 hrs. per week as Full Time.


How is coverage determined to be "Affordable"?


Coverage is considered affordable if employee contributions for the employee ONLY do not exceed 9.5% of an employees household income.

The three safe ways to determine whether an employees coverage is affordable:

  • 9.5% of the employees monthly wages using the hourly wage times 130 hours per month.
  • 9.5% ofthe FPL for a single employee (FPL=Federal Poverty Level).
  • 9.5% of the employees W-2 income reduced byany salary reductionsunder a 401K plan or Cafeteria plan.

Who is considered to be a "Dependent"?

Children up to age 26 are Dependents.  This excludes step children and foster children.  The legislation did not consider spouses as "dependents", so employers are not requered to offer coverage to spouses.

Categories: 2016-Employer Groups with 100 or more Employees

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