What to Know About the Affordable Care Act Before Open Enrollment Begins

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Originally posted by Breedlove & Associates here.

Lately we’ve been inundated with questions about health insurance – specifically relating to the Affordable Care Act because the 2015 open enrollment is coming up on November 15th. So to help clear up any confusion families may have, here is a simple Q&A that may help.

What is the Affordable Care Act?

The Patient Protection and Affordable Care Act, commonly referred to as the “Affordable Care Act” or “Obamacare,” is a federal law aimed at reducing the overall cost of health care and decreasing the number of uninsured individuals living in the United States.

Is my employee required to have health insurance?

Yes, your employee – like all Americans – is subject to penalties if she does not have health insurance coverage. However, you are not responsible for making sure your employee has health insurance.

Am I required to offer health insurance to my employee(s)?

No, employers are not required to offer health insurance if they employ fewer than 50 workers. However, you are required to provide your current employee and, at the time of hire, any future employee with a notice about the Health Insurance Marketplace.

What is the Health Insurance Marketplace?

The Health Insurance Marketplace is the government-run health insurance exchange – a “one-stop shop” where individuals can compare and purchase health insurance policies. Open enrollment for the Marketplace opens on November 15th for coverage beginning January 1, 2015. Your employee will be able to purchase health insurance through the Marketplace until open enrollment ends on February 15, 2015.

How much will health insurance cost?

The cost of health insurance will vary depending on the state and the options your employee chooses (deductible, co-pay, etc.). After completing an application, your employee will be able to compare prices and coverage options for different health insurance policies. Depending on her income and family size, she may be eligible for a subsidy if she purchases her insurance policy through the Marketplace. However, she must have documented wages in order to get a discounted policy – meaning she must be paid legally. The Kaiser Family Foundation has a helpful Subsidy Calculator to estimate how much she’ll save.

If I contribute to my employee’s health insurance policy, will I be eligible for any tax breaks?

If you contribute to your employee’s health insurance premium, the amount of your contribution is considered “non-taxable compensation” – so neither you nor your employee would have any taxes on that portion of the compensation. In addition to the non-taxable advantage, if you set up a health insurance policy for your employee through SHOP (Small Business Health Options Program) on the Marketplace and pay at least 50% of your employee’s premiums, you may be able to take advantage of the Credit for Small Employer Health Insurance. To take this credit, you’ll attach Form 8941 to your personal income tax return. The credit is up to 50% of the contribution you pay. For more information regarding the requirements for contributing to health insurance, please contact our office as SHOP is a relatively new program and the details may change.

We understand that many families are tackling this issue for the first time and may still have questions after reading this. Please don’t hesitate to send them our way. Our tax experts are happy to help Monday through Friday from 8am to 6pm CST.

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