Potential Employer Penalties Under the Patient Protection and Affordable Care Act (ACA)

Abstract

[Excerpt] The Patient Protection and Affordable Care Act (ACA, P.L. 111-148, as amended) was intended to expand insurance coverage in the U.S. To ensure that employers continue to provide some degree of coverage ACA includes a “shared responsibility” provision. The provision does not explicitly mandate that employers offer their employees acceptable health insurance. However, it does impose penalties on certain firms with at least 50 full-time equivalent employees, if one or more of their full-time employees obtain a premium tax credit through the newly established health insurance exchanges. An individual may be eligible for a premium tax credit if his or her income is below certain thresholds and the individual’s employer does not offer health coverage, or offers insurance that is “not affordable” or does not provide “minimum value,” as defined by ACA. The employer penalties are effective beginning in 2014. This report describes the potential employer penalties, as well as proposed regulations to implement the ACA employer provisions. The regulations address insurance coverage requirements; methodologies for determining whether a worker is considered full time; provisions relating to seasonal workers and corporate franchises; and other reporting requirements.