IRS Proposes Employer Mandate Rules for Health Coverage
The Internal Revenue Service has issued proposed regulations on the shared responsibility for large employers to provide health care coverage under the Affordable Care Act.
The IRS noted that employers may rely on the proposed regulations for guidance until final regulations are issued. In addition, the IRS posted a questions and answers document on its Web site Friday to explain the Employer Shared Responsibility provisions under the Affordable Care Act and the new proposed regulations.
Under the provisions, if employers do not offer affordable health coverage that provides a minimum level of health insurance coverage to their full-time employees, they may be subject to an Employer Shared Responsibility payment if at least one of their full-time employees receives a premium tax credit for purchasing individual coverage on one of the new Affordable Insurance Exchanges.
Businesses that do not provide health insurance coverage may be subject to a penalty of $2,000 per employee per year if over 30 employees are subsidized by the tax credits. Employers need to provide "affordable" coverage that does not cost a single employee over 9.5 percent of their income, although the amount may be more for family coverage.
In order to be subject to the provisions, an employer must have at least 50 full-time employees, or a combination of full-time and part-time employees that is equivalent to at least 50 full-time employees (for example, 100 half-time employees equals 50 full-time employees). A full-time employee is considered to be an individual employed on average at least 30 hours per week. Half-time would be 15 hours per week.
The Employer Shared Responsibility provisions generally go into effect on Jan. 1, 2014, but employers will need to use information about workers they employ during 2013 to determine whether they have enough employees to be subject to the new provisions in 2014.
In 2014, if an employer meets the 50 full-time employee threshold, the employer generally will be liable for an Employer Shared Responsibility payment only if: (a) The employer does not offer health coverage or offers coverage to less than 95 percent of its full-time employees, and at least one of the full-time employees receives a premium tax credit to help pay for coverage on an insurance exchange; or (b) the employer offers health coverage to at least 95 percent of its full-time employees, but at least one full-time employee receives a premium tax credit to help pay for coverage on an insurance exchange, which may occur because the employer did not offer coverage to that employee or because the coverage the employer offered that employee was either unaffordable to the employee or did not provide minimum value.
After 2014, the rule in part (a) applies to employers that do not offer health coverage or that offer coverage to less than 95 percent of their full time employees and the dependents of those employees.
A public hearing will be held on the proposed regulations on April 23 and is accepting written or electronic comments until March 18.