Are Employers Required To Offer Health Insurance?

Medical costs in the U.S. are high, which is why a lot of employees look for a job that offers health insurance. Over 88% of people consider health insurance benefits when choosing a job. For companies, providing group insurance to

cartoon of a man in a suit pointing at a clipboard with magnifying glass over a certain part.
There is no specific law that requires employers to provide health insurance coverage to their employees, but there is a penalty.

employees costs a lot of money, so some companies opt out of providing insurance. But are they required to? Yes, and no.

 

 

 

Affordable Healthcare Act

There is no specific law that requires employers to provide health insurance coverage to their employees. However, in January of 2015, the Affordable Care Act, ACA, required that employers who have 50 or more full-time employees provide health insurance. If they do not, they will face a tax penalty.

According to the ACA, full-time employees are employees who work an average of 50 hours a week.

Group Insurance Penalties

If a larger company with 50 or more full-time employees does not offer health insurance, they are subject to IRS penalties. 

The IRS will penalize the company if one or more of their full-time employees gets a premium tax credit for getting their own health insurance coverage from the Marketplace. The company can owe up to $2,500 for each employee. 

gavel with money sign on the wood

The company must offer insurance to 95% of their employees to avoid a penalty, and it must be year round. If the business offers healthcare for some months, and not others, then they will face a portion of the annual penalty.

Small Businesses

people working inside many cubicles.
Small businesses (less than 50 employees) do not have a penalty if they do not offer health insurance to their employees.

Small businesses are not required to offer healthcare coverage to their employees. Since they have less than 50 full-time employees, they will not face penalties. If a small business does not offer health insurance, then a person can seek their own health insurance plan from the Marketplace or a private company.

While there is no longer a penalty for going without healthcare coverage, it is important to seek out information on different plans. There are plans within your budget that will meet your needs and lifestyle. If you need help searching and comparing all the group insurance plans around, EZ.Insure can help. We offer local specialized insurance agents that can do all the comparisons for you, and just provide you the quotes. All for free! It’s that simple. To begin, enter your zip code in the bar above, or to speak to an agent, email [email protected], or call 888-998-2027. There is no hassle involved, and no obligation to buy, and no headaches. Just easy, fast, and free quotes!

QSERHA vs. Group Health, Whats Best For Your Company

Small business owners know the value of covering their employees. After all, everyone gets sick at some point. If you support your team’s wellness, you make a stronger team.

You might also see the value in comparing and then choosing the best option. Two of these are either QSERHA or group health insurance, but which one has the most value for your business? For the answer to that question, we’ll need to break each one down first.

It is important to sit down and compare all the options available to your business.

QSERHA 

This choice was unavailable until now. The ACA has now widened the usefulness of HRAs. Previously, you couldn’t set up an account unless it was tied to a policy. For more info on this, read about 2020 HRA changes here. Thankfully, this puts a Qualified Small Employer Health Reimbursement Arrangement or QSERHA on the menu. 

So, what does it offer for your business?

This option skips the sometimes expensive group health insurance plans. While you’re missing out on the robust coverage insurers provide, the cost-saving benefits might be redistributed amongst your employees. 

With this HRA, you must follow the requirements: employees must already have minimum health insurance, and you have to set-up your HRA properly.  Afterward, you simply make contributions to the account, and later, the funds will be available to help pay for your employee’s medical expenses, tax-free.

Group Health

It comes down to which is better for your business. To help guide your decisions, see what your answers to these questions are:

  • Do my employees need healthcare assistance?
  • Is everyone on staff covered by an HRA already?
  • Does my budget include funds for a robust insurance option?

After answering these, you should have a better idea of which option to go for. If not, then consider the following:

QSERHA Group Health
Cost You can choose how much you contribute to the account. Premiums vary by provider but are generally more expensive.
Participation All employees must be offered coverage, but they do not have to accept. Generally, around 60% of your staff must be enrolled to qualify.
Coverage Can’t be in tandem with group health.

Employers can choose to reimburse medical expenses or premiums.

Primarily covers medical, dental, and vision
Eligibility  1-49 full-time employees 2-50 employees 

Note: some states requirements go up to 100

 

Hopefully, this chart helps guide your decision. No matter which you choose, remember that the health of your employees is important to your continued business. A healthy team is a happy team. However, if your budget allows, consider choosing the group health option. You’ll have an agent to help you with the tough questions plus the bonuses offered are well worth the price tag.

 

If you are looking to get more coverage for your company, EZ.Insure offers solutions. Your personalized agent will answer any questions you have, compare the plans available to you, and even sign you up when you are ready, free of charge. To get started simply enter your zip code in the bar above, or you can speak to an agent by emailing [email protected], or calling 888-998-2027. EZ.Insure makes the entire process simple, easy, and quick.

 

ATTN Small Business Owners: 6 Reasons You Should Give Your Employees Insurance

Not convinced small business coverage is worth it?  Find out why we think it is.

1. It’s Cake.

As a business owner, your greatest currency is time. So the last thing you want is to waste that on looking for the right group plan.

When you hire an agent, you hire a full-time tour guide committed to navigating you through the selection process. With demographics, health concerns, and company size to consider, there are plenty of factors that must be included in your final decision.  An agent can explain the nitty-gritty details of selecting a plan that fits your company’s needs, instead of you spending an unbelievable amount of time trying to digest the vast sea of information. Consider them

Cartoon of a man in a suit sitting on a chair with papers in his hand, with another hand in the picture giving paperwork to man sitting down.
An agent can explain the nitty-gritty details of selecting a plan that fits your company’s needs, instead of you spending a large amount of time trying to figure it all out

your “sparknotes” of insurance plans.

This connection is 1-to-1, because trust us – we hate spam calls as much as you do.

Connect With a Personal Agent Now

2. Less Money (From You), Less Problems.

One of the biggest misconceptions about purchasing insurance is the hefty price tag that comes along with it.  And that can be true, if you go about the process in the wrong way. So we’re here to dispel that myth. 

Compared to individual health insurance, high costs of one insured person have a smaller effect in a larger pool – in other words, more people are paying to support the few who use the benefits of being covered to their full extent.

With comparison shopping, you avoid that. You are guaranteed to find the right plan at an affordable price.  You can contribute nothing to a plan – and it will still be beneficial for your employees. No risk is necessary.

It is important to keep in mind that you are not only the owner of your company; you are the owner of the plan selection. 

Checking out your options is a great place to start.

3. “I Want YOU To Buy Health Insurance!”

Little figurines of people passing money to each other from a pile down a line towrds a yellow piggy bank.
You end up saving money by offering employees group insurance. Employer contributions are tax-deductible, employer payroll taxes are reduced by 7.65% of employee contributions, and more!

If you still don’t believe in the affordability of group health coverage, consider this – it’s on Uncle Sam.  Two words for you: Tax. Benefits

Here are the tax savings you get by offering group health insurance:

  • Employer contributions are tax-deductible
  • Employer payroll taxes are reduced by 7.65% of employee contributions
  • Employer workers compensation premiums are reduced
  • No payroll taxes and workers compensation premiums on money used towards health benefits. 

And here are the tax savings your employees get by receiving group health insurance:

  • When employees buy health insurance on their own, they have to use post-tax dollars to buy it. They make money, the government taxes that money, and then they take the remaining amount to buy what they need.
  • When employees buy health insurance through a group plan, they pay for the insurance with pre-tax dollars. That can save them up to 30 to 45% on their health insurance premiums.

4. Healthy Employees = Happy Employees

You might not be able to buy the Beatles’ love, but you can buy your employees’.  

Studies show that small business health insurance plans increase employee loyalty and decrease turnover. There’s scientific proof that purchasing insurance for your employees can increase retention and aid in recruitment.  Mic drop. 

In all seriousness, health insurance is a big deal for both employees and job seekers.  For some, it’s even the deciding 

factor between job offers. 

A group of employees standing in a circle with their hands on top of one another. Camera view is looking up at their palms.
Healthy employees means less visits, less appointments, and less sick days. What this means is more productivity in the workplace.

Providing health insurance, despite not being a large corporate powerhouse, shows how much you value your potential and current employees.  Which – if you’re a good boss – is a lot.

5. And Happy Employees = Happy Boss

You can imagine that an employee with a burst appendix or an inflamed wisdom tooth might be a little distracted when calculating the day’s revenue.  But only a little.

Employees who aren’t provided health insurance have an increased likelihood of avoiding doctor appointments or hospital visits. In short, they have an increased likelihood of being unhealthy.

Additionally, healthy employees means less visits, less appointments, and less sick days.  If you focus on “saving money” at the cost of your employees’ health, we’re tellin’ ya, it’s just going to come back and bite you in the bottom. 

Or your bottom line.

6. The Gift That Keeps on Giving

Cobra isn’t just a snake.

The Consolidated Omnibus Budget Reconciliation Act (COBRA) is a health insurance program that allows an eligible employee and his or her dependents the continued benefits of health insurance coverage in the case that employee loses his or her job or experiences a reduction of work hours. 

Ready to Get Your Cost-free Quote? 

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Turning 26? Your Guide To Getting Health Insurance

The time has come. You made it to 26 with health insurance coverage through your parents. But now your birthday is approaching  and are getting kicked off your parent’s health insurance plan. You may be wondering if you can stay on your parents’ health insurance longer. The answer to this is, unfortunately, no. You will get kicked off the plan at

Birthday cake with canles "26" on it lit.
When you turn 26 years old, tjere is a deadline for your hralth insurance. You will have to get your own plan.

either the end of the month that you turn 26, or at the end of the year.  Its inevitable, but where do you start?

The Options

If you are employed, then you can join your company’s health insurance plan if they have one. Another option is to hop on your spouse’s health plan if you are married. If none of these options apply to you, then your only choice is to get your own health insurance plan. Those options are:

 

  • Long-term Plans

 

When you turn 26, you qualify for a special enrollment period for Obamacare, also known as the Affordable Care Act (ACA). You also have the option of getting private insurance in which licensed health insurance agents are able to create a policy that is unique to your specific needs using a full spectrum of different insurance companies. It is important to shop around because these plans are sometimes cheaper than the marketplace insurance plans. Long-term plans offer more comprehensive coverage. These plans help manage day to day expenses and are convenient for those that require routine medical work, such as medication, lab work, and inpatient/outpatient services. Major medical health insurance complies with the ACA requirements which means it provides the ten essential health benefits.

Essentially, when you are over 26 years old and are no longer on your parent’s plan, then a major medical plan is best if you are looking for coverage of pre-existing conditions, and need routine medical work , such as medication,

Two signs that say short-term and long-term on them pointing in different directions.
The two options for health insurance are short-term and long-term. Short term plans do not cover pre-existing conditions, only the basics.  If you need comprehensive coverage, long-term is best.

lab work, and inpatient and outpatient services. Major medical health insurance complies with the ACA requirements which means it provides the ten essential health benefits. These ten essential benefits are: ambulatory patient services, prescription drugs, emergency care, mental health services, hospitalization, rehabilitative services, preventative and wellness services, laboratory services, pediatric care, and maternity and newborn care.

 

  • Short-Term Plans

 

Unlike long-term plans, their short-term counterparts do not need a qualifying life event to enroll. Short term health insurance provides fast, flexible insurance with many benefits. These plans can be extended up to 3 years, and you can pick your deductible amount from many options. You are also able to drop coverage without a penalty if you want to change to a long term insurance option. Premiums are lower than ACA health insurance plans, and you get coverage as soon as a day after applying.

It is important to understand that short-term insurance is temporary and not ideal for those who require more comprehensive coverage or have health conditions. Short term plans are not guaranteed issue, meaning they do not cover pre-existing conditions. They only cover the basics. 

When you consider purchasing health insurance, you have to think about how much you want to pay, the coverage provided, and which term length is best for you. It can be quite overwhelming when you embark on this new journey. EZ.Insure can help. We will provide you with a highly trained agent within your area that can provide you quotes and plans from all the different health insurance companies in your region. To get started, enter your zip code in the bar above. Or to speak to an agent call 888-350-1890, or email [email protected]. We will go over everything with you and help you decide if this plan best suits your needs. If it does not, then we will direct you to other plans.

Check Your Eligibility For A Premium Tax Credit

In 2014, the Affordable Care Act established the premium tax credit so that individuals or families with low or moderate income can be able to pay for health insurance through the Health Insurance Marketplace. Premium tax credits help you pay for a portion of your monthly cost of insurance premiums. Individuals and families must meet an income requirement to enroll in a health insurance plan through a state-operated insurance marketplace, or a federally-operated marketplace.

There are multiple qualifications for a premium tax credit. One is to calculate your income with the number of people in your household.
There are multiple qualifications for a premium tax credit. One is to calculate your income with the number of people in your household.

Qualifications

  •         You must prove you do not have access to an affordable employer-sponsored program. This plan must meet minimum essential coverage meaning the employee contribution does not exceed 9.5% of the employee’s income.
  •         You must prove you are not eligible for Medicare, Medicaid, or TRICARE
  •         You cannot be claimed as a dependent by another taxpayer.
  •         In the same month, you or a family member must have health coverage through a Health Insurance Marketplace.
  •         You file a joint federal income tax return if you are married; you cannot file married filing separately tax return (unless a victim of domestic abuse or spousal abandonment).
  •         Have a household income that falls within a certain amount.

Income Requirements

In order to be eligible for the premium tax credit, you and your family size must be at minimum 100 percent below the poverty line, but no more than 400 percent. This means the income must be between $12,060 and $48,240 for an individual and between $24,600 and $98,400 for a family of 4 in 2018.

The amount of tax credit is based on a sliding scale. This means the lower your income, then the larger credits you receive.  If your income changes, then the amount of assistance you qualify for will change as well.

2019 Federal Poverty Levels
2019 Federal Poverty Levels

It is important to keep an eye on your household income and how much tax credit you receive. If the advance credit payments are more than the allowed credit, then you will have to repay some or all of the extra earnings. If your household income is more than 400% of the federal poverty line for your family size, then you are not allowed a premium tax credit. You will have to repay all of the advance credit payments.

Advance Tax Credits

A taxpayer can either choose to receive advanced payments, which is paid to the insurance company to lower monthly premium costs, or the taxpayer can wait to get all of the credit when they file their tax return. Eligibility for the advanced payments is determined when purchasing coverage through the marketplace. There is a difference between advance payments to your insurance company and your allowable premium tax credit amount. Form 8962 calculates your tax credit amount that is allowed when you file your tax return.

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