Smart Benefits: Pay or Play Delay Could Bode Well for Employers

Amy Gallagher, GoLocalProv Business/Health Expert

Smart Benefits: Pay or Play Delay Could Bode Well for Employers

The Affordable Care Act’s “Pay or Play” penalty that requires employers to pay penalties for full-time employees to whom they don’t provide affordable, minimum value health insurance is delayed once again. But this time, employers with 50-100 employees will benefit, getting to wait until 2016 before paying the penalty.

Delay Benefits Some Smaller Companies As Well

Some employers with fewer than 50 employees may also benefit. While not subject to the “Pay or Play” provisions of the Affordable Care Act, some smaller companies are on the cusp of having more than 50 employees because of full-time employer determination formulas. Now, even if they cross the “over 50” threshold, they’ll have an extra year before they have to offer insurance.

And Relief for Large Employers, Too

While larger employers must pay the penalty in 2015 (originally delayed from 2014), these groups will get some relief. Next year, they will have to offer insurance to 70% of their full-time employees compared to the 95% required in 2016. And they won’t have to start paying the “Pay or Play” penalties until the start of their plan year in 2015 rather than January 1st.

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New Clarification of Full-Time Employees

To help clarify full-time employees for purposes of the “Pay or Play” penalty, the definition has been explained further. Volunteers, seasonal workers who typically work six months or less and students who participate in federal or state work study programs will not be considered full-time. However, educational employees, like teachers, will be considered full-time, despite time off during the summer.

 

Amy Gallagher has over 21 years of healthcare industry experience guiding employers and employees. As Vice President at Cornerstone Group, she advises large employers on all aspects of healthcare reform, benefit solutions, cost-containment strategies and results-driven wellness programs. Amy speaks regularly on a variety of healthcare-related topics, and is often quoted by national publications on the subject matter. Locally, Amy is a member of SHRM-RI, the Rhode Island Business Group on Health, and the Rhode Island Business Healthcare Advisory Council.

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