Employer Mandate to Be Based on 2013 Numbers
1, 2014, the employer mandate provision of the Patient Protection and
Affordable Care Act (PPACA) will become effective. This provision requires
employers with 50 or more full-time equivalent employees to offer those
employees health insurance benefits that satisfy certain affordability
thresholds. Many employers do not realize that the application of the employer
mandate will be based on the number of employees on the books in 2013.
According to guidance issued on December 28,
2012, the government
will rely on an employer’s 2013 data to determine whether the employer is
subject to a penalty for failure to comply with the requirement. Under the
proposed regulation, if a company has 50 or more full-time equivalent employees
on the record, that employer must provide those employees with insurance that
meets affordability and minimum value requirements.
provides some clarification on how to determine the size of the firm. For
example, employers can choose to calculate the number of full-time equivalent employees
by averaging all 12 months of 2013, or by using a consecutive six-month period
within the year.
will apply if:
1) An employer is subject to the
threshold and either does not provide any coverage.
2) The employer provides insurance
that does not meet affordability or minimum value thresholds, and one or more
employees receives a premium subsidy for coverage obtained via a state health
This guidance should spur employers to make decisions as to the composition of
their work force now. Employers must take a proactive approach to remain
compliant with PPACA and its various provisions.
Please refer to
the BenefitMall whitepaper on employer requirements and
tax implications of PPACA
for additional information on the employer mandate.
Please visit www.healthcareexchange.com for blog posts, polls, surveys and
numerous resources, or www.benefitmall.com to view previous legislative alerts.
Reprinted from HealthcareExchange.com with permission.
About the Author:
C. Gomes, Executive Vice President, BenefitMall
A veteran of the insurance industry, Mr. Gomes brings nearly 30 years of
experience in planning, developing and executing national sales initiatives. As
Executive Vice President of BenefitMall, Mr. Gomes has taken an active role in
educating brokers and employers on the implications of PPACA. Having previously
headed the Life and Health Divisions for the New Jersey Department of Insurance,
Michael brings a unique perspective on Public and Private Partnerships
associated with health care reform. Additionally, he has championed
BenefitMall’s legislative agenda by leading numerous training, public speeches
and court testimonies associated with health care reform and implementation of