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BusinessApril 20, 2015

This year the Affordable Care Act is prompting many changes for businesses -- for some, there is a new requirement to offer health insurance plans or face fines; for others, 2015 is marked as the year businesses can begin offering affordable plans to employees through the federally run marketplace exchange...

Stock photo
Stock photo

This year the Affordable Care Act is prompting many changes for businesses -- for some, there is a new requirement to offer health insurance plans or face fines; for others, 2015 is marked as the year businesses can begin offering affordable plans to employees through the federally run marketplace exchange.

__The employer mandate__

Businesses with 100 or more "full-time equivalent" employees, or FTEs, must provide health insurance coverage to employees and their dependents and can be charged a fine "if at least one full-time employee qualifies for a premium tax credit and uses it to purchase coverage in the health insurance exchange," according to the U.S. Chamber of Commerce's guide to the Affordable Care Act.

Determining FTEs is important for businesses, because those classified as "small," meaning they have fewer than 100 FTEs over the course of a month, don't have to offer coverage to employees.

The employer mandate will expand to include businesses that employ 50 or more FTEs in 2016, according to a list of final regulations published by the U.S. Treasury Department.

Woman's hands with insurance card and prescription slip
Woman's hands with insurance card and prescription slip

Employers that must follow the mandate, or "shared responsibility" rules, in 2015 are required to offer coverage to at least 70 percent of their full-time employees as one of the conditions for avoiding fines, according to the treasury department. In 2016, they must offer coverage to 95 percent.

__New reporting requirements__

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Also new this year is a requirement that self-insuring employers -- no matter their size -- report health insurance coverage information to the Internal Revenue Service, according to the U.S. Small Business Administration. Separate reporting requirements apply to businesses with 50 or more full-time or full-time equivalent employees. The reports, which are detailed by the Internal Revenue Service, must be first filed in 2016.

__SHOP Marketplace now open__

The Small Business Health Options Program, or SHOP Marketplace, the small business version of the individual online health marketplace, now offers coverage plans for employers with 50 or fewer full-time employees, and the marketplace will be expanded in 2016 to include businesses with up to 100 employees. By using the SHOP marketplace, businesses can qualify for a small business health care tax credit worth up to 50 percent of the cost of its premiums, according to healthcare.gov.

Some local insurance agencies can help businesses find plans through the SHOP Marketplace that suit their needs and understand eligibility requirements. Laura Matlock, insurance agent at Van Weelden Insurance Agency in Cape Girardeau, says the agency is qualified to help customers shop for marketplace plans, though the agency hasn't yet seen demand.

"It's not very popular around here yet," she says. "So far we have only helped individuals get signed up."

__Prepare for an increase, possibly__

The cost of premiums associated with Affordable Cart Act plans in 2016 are expected to rise -- some studies and reports say the hike could be significant, others not so much. Rates in 2015 ended up surprisingly close to those in 2014 for individual plans, despite warnings of increased costs. Multiple reports and studies indicate premiums may double; others predict small increases depending on geography and demographics.

__Where to get more information__

The U.S. Small Business Administration's website, www.sba.gov, has articles outlining the "need-to-know facts" about the Affordable Care Act and how it applies to businesses of different sizes, along with weekly educational webinars, which began April 2 and end June 25. Topics covered, according to the website, include cost containment, tax credits for small businesses, the marketplace and the employer mandate.

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