Smart Benefits: ACA Numbers to Know for 2018

Rob Calise, GoLocalProv Business/Health Expert

Smart Benefits: ACA Numbers to Know for 2018

If you’re an Applicable Large Employer (ALE), keep the following numbers in mind before finalizing plan design and employer contribution details for 2018 health benefits:
  • The “affordability” percentage for 2018:  9.56%
  • The maximum monthly affordable contribution under the Federal Poverty Level (FPL) safe harbor:  $96.08
  • The employer mandate “part A” penalty for 2018:  $2,320 ($193.33 / month)
  • The employer mandate “part B” penalty for 2018:  $3,480 ($290.00 / month)

 

While the affordability percentage of 9.56% is down from 9.69% in 2017 and the FPL safe harbor amount of $96.08 is down from $97.38 in 2017, the two penalty amounts are up from $2,260 and $3,390 in 2017.

Affordability Threshold

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Under the ACA, coverage is deemed affordable for an employee if the employee’s required contribution for employee-only coverage does not exceed a specified percentage of the employee’s household income. The IRS has created three safe harbors that employers may use in place of the employee’s household income to determine affordability:  W-2, Rate of Pay, and Federal Poverty Level.

Employer Mandate Penalties

ALEs may be subject to a penalty for (1) failing to offer Minimum Essential Coverage (MEC) to all full-time employees and their dependents – the “part a” or “failure to offer” penalty; or (2) offering coverage that is not affordable or does not provide Minimum Value – the “part b” penalty.

Calculating the penalty for failure to offer Minimum Essential Coverage: In 2018, the penalty is $2,320 per full-time employee, excluding the first 30 full-time employees. Before the penalty will apply, at least one full-time employee must enroll in exchange coverage and must receive a premium tax subsidy for that coverage. Part-time employees are not included in the penalty calculation.

Calculating the penalty for offering coverage that is unaffordable or does not provide Minimum Value: In 2018, the penalty is $3,480 per full-time employee who receives a premium tax credit for exchange coverage. The total penalty cannot exceed the amount that the employer would have owed if it had been liable for the failure to offer penalty.

Rob Calise is the Managing Director, Employee Benefits of The Hilb Group of New England, where he helps clients control the costs of employee benefits by focusing on consumer driven strategies and on how to best utilize the tax savings tools the government provides. Rob serves as Chairman of the Board of United Benefit Advisors, and is a board member of the Blue Cross & Blue Shield of RI Broker Advisory Board, United HealthCare of New England Broker Advisory Board and Rhode Island Business Healthcare Advisors Council. He is also a member of the National Association of Health Underwriters (NAHU), American Health Insurance Association (AHIA) and the Employers Council on Flexible Compensation (ECFC), as well as various human resource associations. Rob is a graduate of Bryant University with a BS in Finance. 

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