Tuesday, August 23, 2016

Important ACA Terminology Refresher for Employers Offering Employee Health Benefits


The IRS has issued a new tax tip reminding employers of key provisions they need to understand under the Affordable Care Act. In general, under the employer shared responsibility provisions of the Affordable Care Act, an applicable large employer may either offer affordable minimum essential coverage that provides minimum value to its full-time employees and their dependents or potentially owe an employer shared responsibility payment to the IRS.

The IRS highlights two key terms for employers to understand:
Affordable coverage: If the lowest cost self-only health plan is 9.5 percent or less of a full-time employee’s household income, then the coverage is considered affordable. Because employers likely will not know your employee’s household income, for purposes of the employer shared responsibility provisions, employers can determine whether they offered affordable coverage under various safe harbors based on information available to the employer.

Minimum value coverage: An employer-sponsored plan provides minimum value if it covers at least 60 percent of the total allowed cost of benefits that are expected to be incurred under the plan.

Under existing guidance, employers generally must use a minimum value calculator developed by the Department of Health and Human Services and the IRS to determine if a plan with standard features provides minimum value. Plans with nonstandard features are required to obtain an actuarial certification for the nonstandard features. The guidance also describes certain safe harbor plan designs that will satisfy minimum value.

For more information, visit the Affordable Care Act Tax Provisions for Employers pages on IRS.gov/aca, including Minimum Value and Affordability page.
AHCA/NCAL members are saving money on their employee health benefit programs through AHCA/NCAL Insurance Solutions. One independent owner in Florida recently saved more than $1,000 annually per employee. To explore your health plan options available through AHCA/NCAL Insurance Solutions, contact Dave Kyllo at 202-898-6312 or Nick Cianci at 202-898-2841 or email us at ahcainsurancesolutions@ahca.org.

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