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2015 & 2016 Guidelines (100+)

Click here to review guidelines for groups with 50 – 99 employees.

Employer Penalities for 2015 and 2016

A” PENALTY 4980H (a)

  1. No offer of minimum essential coverage (MEC)
  2. Trigger: FT employee gets Premium Tax Credit (PTC) from Exchange – no penalty for Medicaid enrollment
  3. $2,000 x all FT employees
  • 2015: minus first 80 FT employees
  • 2016: minus first 30 FT employees

NOTES:

  • Must offer to “all” FT employees
  • Regulators define “all” as 95% (all but greater of 5% or 5 FT)
  • For 2015, lowered requirement to 70%
  • In 2016, 95% applies

B” PENALTY 4980H (a)

  1. Coverage is not “affordable” or does not provide minimum value
  2. Trigger: FT employee gets Premium Tax Credit (PTC) from Exchange
  3. $3,000 x each FT employee who gets PTC from Exchange; never higher than employer would have received for “A” Penalty

NOTES:

  • A 100+ employer that avoids the “A” Penalty in 2015 could be subject to the “B” Penalty if FT employee (part of 30% not offered MEC) gets PTC from Exchange
  • In 2016, 50+ employer that avoids “A” Penalty could be subject to “B” Penalty if FT employee (part of 5% or 5 FT not offered MEC) gets pTC from Exchange

EITHER PENALTY MAY APPLY BUT NOT BOTH 

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