Keller works closely with clients to determine the compliance steps for the Employer Shared Responsibility provision of the ACA. This is one of the most onerous current aspects of the ACA due to stricter eligibility requirements, detailed reporting, complex measurement rules, and large penalties. It is often referred to as the “play or pay” provision since employers may choose to be compliant by offering coverage within the ACA regulations or pay penalties.
Enforcement of the mandate began in 2015. To be compliant, employers with 100 or more full-time equivalent employees in 2014 must offer medical coverage to at least 70% of full-time employees and their children. Starting in 2016, employers with 50 or more full-time equivalent employees in a prior calendar year must offer medical coverage to at least 95% of full-time employees and their children.
The medical coverage must be both “minimum value” and “affordable” under ACA standards. If a full-time employee is not offered affordable coverage and instead enrolls in a Marketplace plan with a federal subsidy, a penalty may be assessed to the employer.
Keller assists our clients in determining if there are any full-time employees who may not currently be offered coverage but may need to be offered coverage in the next plan year, such as interns, other short-term hires, seasonal or variable hour employees. In addition, we use the available employer safe harbors to ensure that the employee’s cost meets the affordability standards.
We also advise on the detailed reporting of employee enrollment information that must be filed with the IRS beginning in 2016.