FAQs for Small Employers
The following questions and answers prepared by ORLA's healthcare expert, Garth Rouse, are intended to be used for general information about the Affordable Care Act (ACA). Before implementing any benefit changes please consult a professional specializing in
this field as this law is continuously changing and evolving.
If you are an employer with fewer than 50 FTE’s (small employer):
Q: Will I be required to offer health insurance coverage in the future?
A: No, the Affordable Care Act (ACA) does not require you to offer coverage. There will be penalties for larger employers who don't offer coverage: employers with 50-99 FTE’s must offer coverage starting in 2016, and employers with 100 or more FTE's must offer coverage starting in 2015.
Q: If I am an operator that is not considered a large employer, should I even care about this legislation?
A: Yes, for reasons too numerous to mention here, but following are important:
Q: When is open enrollment for Oregon's exchange?
Beginning January 1, 2014 almost all citizens of the United States will be required to have health insurance coverage or pay a penalty. This is known as the “Individual Penalty” and includes you and your employees. Depending on your income, you may be eligible for tax credits to help pay for monthly premiums. For example, an individual earning up to $45,900 a year or a family of four earning up to $94,200 a year will get a tax credit to help cover the cost of their premiums. You may also be eligible for cost-sharing assistance to help pay for copays, deductibles, and other out-of-pocket costs. You will be able to find out if you are eligible for financial assistance by answering a series of questions on the Cover Oregon website.
Oregon small businesses can take advantage of the IRS Small Business Health Care Tax Credit. The act requires all employers to comply with certain requirements; read more at Cover Oregon.
A: Open enrollment for coverage to begin in 2014, is from October 1, 2013, through April 30, 2014.
Q: How much are the subsidies?
A: They range based on age, income, and number of people covered.
Q: What is the Individual Penalty for not being covered?
A: In 2014 it is the greater of $95 per person ($47.50 per child) up to a maximum of $285 or 1% of your adjusted gross pay. In 2015 the numbers go to $325 per person (maximum of $975) or 2% of adjusted gross pay. By 2016 the amounts are $695 per person (max of $2,085) or 2.5% of adjusted gross pay.
Q: If I offer my employees group insurance coverage at work, are they eligible for the government subsidy?
A: Not if the plan you offer meets “Minimum Essential Coverage.”
Q: If I am offering coverage to my employees now, will I have to change plans?
A: No. You are not required to change plans, but you may be subject to (individual) penalties if your plan does not meet “Minimum Essential Coverage.” You will want to check with your insurance agent or insurance company to see if your plan meets this definition.
Q: What is the difference between buying an insurance plan through Cover Oregon and buying a plan directly from an insurance company?
A: Through Cover Oregon, individuals can check their eligibility and apply for public healthcare programs, such as Medicaid. They will also be able to apply for financial assistance (tax credits and cost-sharing assistance) to help make private health coverage more affordable. Although Cover Oregon cannot yet serve small business, small employers are still able to apply for the small business tax credit.
Q: I have other questions about the healthcare law and providing insurance to my employees, how do I get those answered?
A: You can submit a healthcare question via email or call ORLA at 800.462.0619. Visit Cover Oregon for health insurance questions or talk with your advisors.