Businesses & the Affordable Care Act

Oct 1, 2013

Although the federal health insurance Marketplace for small businesses has been delayed until next month, employers still have some obligations that they must meet this week under the Affordable Care Act. 

That includes telling employees about the  launch of the individual Marketplace, where employees MAY find coverage options through the approved plans. 

All employers must distribute a U.S. Labor document that informs employees of the Marketplace and options. 

Monty Dise is President of the Asset Protection Group and a Virginia Health Reform Initiative Advisory Council member.  Dise says employees also need to know that they can use the Marketplace only if they do not have “affordable” coverage. “So if the employer’s health insurance that’s being offered to an employee—the employee-only share—if that is more than nine-and-a-half percent of their household wage, then the insurance is not deemed ‘affordable,’ and then they can go to the exchange.”

He says only those with household incomes below 400 percent of the poverty level will qualify for subsidies and credits. “If you get to about 250 percent of the federal poverty level, then not only are you going to have your premiums paid, you will also be eligible for what’s called a cost-sharing reduction—for the government to step in and pay part of your deductible and co-insurance.”  

Dise says if income rises above the threshold, then subsidies must be paid back.  He adds that employees should also be told about Medicaid and children’s health insurance programs.

Many companies are inviting insurance agents to come speak to their employees to further explain all of their options both inside and outside of the Marketplace.