Focus On Affordable Care Act Will Help Drive Adp’s Sales

The ACA requires you to notify new hires of their health insurance coverage options and verify employment and benefits for those who choose to participate in Health Insurance Marketplaces (aka “Exchanges”). You must also remit penalty payments when you don’t offer qualifying health insurance to eligible employees and you have full-time employees who receive premium subsidies for coverage obtained through a Marketplace/Exchange. ADP is developing solutions to provide post-enrollment verification information to Marketplaces/Exchanges, generate annual health coverage reports for your workforce, and help manage and reconcile penalty assessments. It’s the requirement in the ACA that employers with 50 or more FTE employees must offer affordable, minimum value health insurance to their full-time workers or face a penalty, according to the IRS.

However, large U.S. employers have been fairly effective in managing overall healthcare costs despite concerns over ACA mandates, according to the2015 ADP®Annual Health Benefits Reportfrom theADP Research Institute®. A plan that provides minimum value will cover at least 60 percent of average health care costs for a standard population and will provide substantial coverage for hospitalization and physician services. If your business is subject to the employer shared responsibility provision , you have to offer coverage that provides minimum value in order to avoid triggering a penalty. For employers with more than 100 full-time employees , this credit is available for wages paid to employees that provided no services during the shutdown. Tomassetti has been involved with the ACA since its launch in 2015.

Coronavirus Aid, Relief, And Economic Security Act (cares Act): Employer Tax, Retirement, Paid Leave And Unemployment

Businesses with fewer than 50 FTEs are not subject to the employer mandate. In most cases, businesses with 50 or more employees were already providing health insurance coverage to their employees prior to the ACA’s implementation.

In the beginning, employers focused their attention on preparing and delivering forms. Then, in the fall of 2017, the U.S. federal government began activating additional pillars of the ACA. For example, the threshold for how many ACA-eligible employees to whom an employer had to offer health insurance was 75 percent in 2015, and that compliance threshold rose to 95 percent in 2016. A critical part of the original ACA was the individual mandate, a provision requiring all Americans to have healthcare coverage—either from an employer or through the ACA or another source—or face increasingly stiff tax penalties. This mandate served the double purpose of extending healthcare to uninsured Americans and ensuring that there was a sufficiently broad pool of insured individuals to support health insurance payouts. The ACA was designed to reduce the cost of health insurance coverage for people who qualify.

The CARES Act also reduces the cost of participation in the program by providing fee waivers, an automatic deferment of payments for up to one year, and no prepayment penalties. This is used to determine whether an employer is subject to the ACA’s requirement to offer health insurance to full-time workers. All employees who work at least 30 hours a week are considered full-time. But the full-time equivalent calculation ensures that employers don’t just bump a majority of their workers down to under 30 hours per week in order to avoid the mandate altogether. Private-sector employers are allowed a refundable tax credit against employer Social Security tax equal to 50 percent of wages paid by employers to employees during the COVID-19 crisis, up to $10,000 per employee.

“Most large employers, who have offered health benefits through self-funded plans for years, appear to have made appropriate adjustments to contain costs while complying with the ACA,” said Christopher Ryan, vice president, Strategic Advisory Services at ADP. ROSELAND, NJ /15/16 — The results of the2016 ADP® Health Benefits Reportreflect that employer-provided healthcare plans in the large employer market are stable, and employers are effectively adjusting to changes mandated by the Affordable Care Act . Changes in costs have been modest, and shifting demographics in the workforce are keeping overall growth of cost per employee lower than in the past. The data analyzed from 2014 to 2016 reflects stability in the way employer-sponsored benefits at large organizations are offered and consumed. Data from 2013 and 2015 was closely analyzed-two years marking the points before and after key ACA provisions went into effect-and revealed how employers may be responding to healthcare reform. – April 15, For employers who offer health coverage to their employees, the Affordable Care Act has introduced sweeping changes that impact everything from medical plan design and eligibility determination to employee communications, compliance reporting, and tax filings.

Affordable Care Act Terminology For Benefits Managers

Small businesses should work with an experienced financial advisor to carefully assess available assistance programs to determine the interplay and best option for their specific circumstances. The Affordable Care Act has brought about significant changes for employer-sponsored health insurance plans over the last few years, and there are even more changes in the pipeline. While the ACA has been in place for years, getting back to basics and understanding the ACA terms that apply to employer-sponsored health plans will make it easier to know how the law impacts your business and your employees’ benefits. Specifically, this is the first year that employers subject to the ACA must track detailed information about health care coverage—including offers of coverage and the full-time status of employees. However, as we approach 2016, the ACA’s reporting requirements will require even more rigorous attention from HR, benefits, and payroll directors.

The CARES Act expands the allowable uses for loans under this program to permit payroll support, including paid sick leave, supply chain disruptions, employee salaries, mortgage payments and other debt obligations, to provide immediate access to funds for affected small businesses. The CARES Act increases the maximum loan amount for SBA Express loans from $350,000 to $1,000,000, until December 31, 2020.

Qualified Wages:

The ADP® Annual Health Benefits Report leverages anonymous and aggregated data from ADP’s client community spanning 2014 to 2016. ADP’s unique employee-level data enables it to analyze dynamics at both the employer level and on a participant basis, most notably as they relate to benefits participation, demographics, and health plan premiums paid by employees and employers.

In its webcast, ADP had covered a numbers of aspects regarding the ACA such as its applicability, healthcare options and related tax credits. However, the Employer Shared Responsibility provision of the ACA is the most important of all. The ESR provision of the ACA requires businesses with 50 or more full-time employees, including full-time equivalent employees, to provide health insurance to at least 70% of the employees in their 2015 plan year. The Coronavirus Aid, Relief, and Economic Security Act (H.R. 748, “CARES Act”) was signed into law on March 27, 2020.

Qualified wages are wages and compensation paid by an eligible employer to employees after March 12, 2020, and before July 1, 2021. Qualified wages include the eligible employer’s qualified health plan expenses. The definition of qualified wages also depends, in part, on the average number of full-time employees employed by the eligible employer during 2019. Private-sector employers may be eligible for a refundable tax credit against federal employment taxes for “qualified wages” paid by employers to employees during the COVID-19 crisis. The tax credit was set to apply to qualified wages paid after March 12, 2020, and before January 1, 2021. However, the Taxpayer Certainty and Disaster Tax Relief Act of 2020, signed by President Trump on December 27, 2020, extends the tax credit to cover qualified wages paid through June 30, 2021.

How To Cut Your Costs For Marketplace Health Insurance

In total, the “matched” set of nearly 200 U.S.-based organizations was comprised of approximately 500,000 employees each year. All organizations used in this study had 1,000 or more employees for at least one of the five years and no fewer than 800 in any given year. For this study, the ADP Research Institute focused on nonunion, full-time employees. “As employers continue to adapt to the evolving healthcare landscape, they can track how they compare with the broader workforce analyzed in this study.”

• Businesses with fewer than 50 FTEs are not subject to the employer mandate.
• You must also remit penalty payments when you don’t offer qualifying health insurance to eligible employees and you have full-time employees who receive premium subsidies for coverage obtained through a Marketplace/Exchange.
• ADP is developing solutions to provide post-enrollment verification information to Marketplaces/Exchanges, generate annual health coverage reports for your workforce, and help manage and reconcile penalty assessments.
• The ACA requires you to notify new hires of their health insurance coverage options and verify employment and benefits for those who choose to participate in Health Insurance Marketplaces (aka “Exchanges”).
• It’s the requirement in the ACA that employers with 50 or more FTE employees must offer affordable, minimum value health insurance to their full-time workers or face a penalty, according to the IRS.

The law includes premium tax credits and cost-sharing reductions to help lower expenses for lower-income individuals and families. Total health premium cost per employee rose 5.0% from 2014 to 2016. This moderate cost trend is likely due to focused cost management on the part of employers, including the use of self-funding, high deductible health plans, employee health and wellness programs, and resources to assist with provider selection. The ADP Research Institute® used anonymous, aggregated, employee-level yearly panel data from a set of employers spanning 2011 to 2015. This research considered the same set of organizations each year in order to provide consistent comparisons across years.

The law provides consumers with subsidies (“premium tax credits”) that lower costs for households with incomes between 100% and 400% of the federal poverty level. The health plan you offer will be considered “unaffordable” if an employee’s contribution for employee-only coverage exceeds 9.5% of the employee’s household income for the taxable year. (For these purposes, household income is only what you pay your employee.) Several affordability safe harbors are available for employers. ADP is developing solutions to help you evaluate your plan’s affordability and minimize penalties to your company.

Requiring that all individuals purchase and maintain health insurance coverage regardless of whether they needed or wanted it, was intended to overcome both the adverse selection and moral hazard problems that the other provision of the law would predictably create. Every year, there is an open enrollment period on the Health Insurance Marketplace during which people can buy or switch their insurance plan.

The credit may be increased by the proportionate share of the employer’s health costs related to such wages. President Trump signed the Coronavirus Aid, Relief, and Economic Security Act (CARES Act, Public Law No. ) into law on March 27, 2020. This expansive 880-page law is intended to offer substantial federal government support to individuals, businesses, hospitals, and specific industries in dealing with the COVID-19 pandemic and its associated economic consequences. A group health insurance plan offers coverage at a lower premium than an individual plan and is available to employees of a company or organization. In the meantime, healthy people would even have an incentive to engage in more behaviors that put their health at risk, secure in the knowledge that they would be guaranteed coverage if their behavior produced poor health outcomes; the problem of moral hazard.

Responsive Support

The CARES Act is the third stimulus bill aimed at providing relief to employers and individuals affected by COVID-19. Below is a high-level summary of the provisions related to small business assistance, tax, retirement, paid leave, unemployment insurance, and direct payment to individuals.