Obamacare for Small Businesses
Empowering Small Businesses with Quality Obamacare Coverage
Protect your business with comprehensive coverage offered by Affordable Care Act (ACA) or Obamacare offers. And we are here to help you choose the right Obamacare health coverage.
What is Affordable Care Act for Small Businesses
Employers can enroll through private insurance companies or with assistance from a SHOP-registered agent or broker.
How Do Health Insurance Subsidies Work?
Incorporating health insurance costs into your monthly budget is crucial, and ACA subsidies can significantly ease this burden. By lowering your premium costs, these subsidies help you manage healthcare expenses more effectively, allowing you to focus on other important financial commitments.
Types of ACA Subsidies
1. Advanced Premium Tax Credit (APTC):
- Purpose: APTC lowers your monthly premium payments for health insurance.
- Eligibility: Based on your estimated income, household size, and the cost of health coverage in your state.
- Usage: You can apply the APTC directly to your monthly insurance payment, reducing upfront costs.
- Tax Considerations: At the end of the year, if you use more tax credits than you were entitled to according to your actual income, you’ll need to pay back the difference when filing your federal tax return. Conversely, if you use less, you’ll receive a refund.
2. Cost-Sharing Reductions (CSRs):
- Purpose: CSRs reduce out-of-pocket expenses, such as deductibles, coinsurance, copays, and out-of-pocket maximums.
- Eligibility: Must enroll in a Silver plan to benefit from CSRs.
- Benefits: You can be eligible for both APTC and CSRs, maximizing your savings on annual health plan costs.
How to Qualify for an ACA Subsidy
Several factors are considered when it comes to determining your eligibility for the ACA
- Income Level: Compared to the Federal Poverty Level (FPL).
- Household Size: Including yourself and dependents.
- State Coverage Costs: The average cost of health coverage in your state.
Eligibility Breakdown:
- 100% to 250% of FPL: You may qualify for both APTC and CSRs.
- Above 250% of FPL: You may still be eligible for APTC and pay no more than 8.5% of your annual income on premiums.
Know the ACA Requirements for Employers
Employee Notifications About the Marketplace
Employers must inform their employees about the health insurance Marketplace, regardless of whether they offer health coverage.
90-Day Waiting Period
Employers offering health insurance must make it available to all eligible employees within 90 days of their eligibility.
Summary of Benefits and Coverage (SBC)
Employers are required to provide employees with an SBC form that outlines the details of their health plan. Non-compliance may result in penalties.
Flexible Spending Accounts (FSAs)
Employees are limited in how much they can contribute to FSAs, although employer contributions are exempt from this cap. Employers can allow employees to carry over unused FSA funds into the next year.
Workplace Wellness Programs
The ACA incentivizes wellness programs, allowing employers to receive up to 30% of the cost of health coverage as a reward, with a higher incentive of up to 50% for programs targeting tobacco use.
Employer Shared Responsibility Payment
Businesses with 50 or more full-time employees may be subject to a payment if they do not offer health insurance that meets specific standards. However, small employers with fewer than 50 employees are exempt from this payment.
Reporting Requirements
Certain employers, health insurance companies, and self-insuring employers must report health coverage details to the IRS.
Medical Loss Ratio Rebates
Insurance companies must spend at least 80% of premium dollars on medical care. If they fail to meet this requirement, they must provide rebates to policyholders, which employers must appropriately distribute
Are There Health Insurance Subsidies for Dental and Vision Coverage?
Some ACA health plans include dental and vision coverage or embedded plans. Subsidies can lower the cost of these plans, especially for children’s coverage, which must consist of dental and vision benefits.
Keep in mind that your standalone dental and vision plans are not eligible for subsidies.
