Group Health Plan Changes
You'll notice changes to the health plans you offer your employees, such as:
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No pre-existing condition waiting period Prior health issues won't limit your employees' health coverage. |
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90-day waiting period The waiting period you set before your workers can join your group health plan can't be longer than 90 days. |
Nearly all U.S. citizens and
lawfully present residents must
have health insurance or pay a penalty.
Wellness Incentive Programs
If you offer a wellness incentive program based on:
|
Health improvements The top reward can rise up to 30% of the cost of health plan coverage. |
|
Stopping or lowering tobacco use Rewards can rise up to 50% of the cost of health plan coverage. |
Employer Shared Responsibility (ESR) Rules
All large employers should know about the ESR penalty that starts in 2015.
Starting in 2015, your large business may face a penalty if you:
- Don't offer minimum essential coverage to your full-time workers
- Offer coverage to your full-time employees but it doesn't have minimum value (covers 60% of employee health care costs)
- Offer coverage to your full-time workers but it isn't affordable (workers pay more than 9.5% of their income for the lowest-cost, self-only coverage)
However, you may avoid this penalty if you:
- Have between 50 and 99 full-time employees and meet certain ACA conditions
- Offer coverage to 70% of your full-time employees (and dependents) in 2015*
- Offer coverage to 95% of your full-time employees (and dependents) in 2016*
*This rule applies whether you intentionally — or unintentionally — don’t offer coverage. Employers won’t avoid the penalty for offering inadequate coverage if any of the full-time employees, including those who aren’t offered coverage at all, receive a premium tax credit or cost-sharing subsidy for purchasing coverage through the Health Insurance Marketplace.
Since this is an overview, detailed information on this
topic — and more — is available.
