Healthcare Reform Timeline

Healthcare Reform Timeline 2015

 

Mandatory Insurance for Employers

The requirement for large employers to offer health coverage has been pushed back to 2015. To avoid paying penalties, employers with 50 or more full-time employees or combination of full-time employees and full-time equivalent employees must offer the following to at least 95 percent of full-time employees and their dependents (children, but not spouses):

  • Coverage that is affordable, meaning that the employee’s share is not greater than 9.5 percent of their household income. An employer may use the employee’s W-2 wages to determine affordability. Whether coverage is affordable is based on the lowest cost individual-only plan available to the employee, even if the employee chooses family coverage.
  • A plan that provides at least minimum value, which means that the plan’s estimated share of benefits provided is at least 60 percent of typical healthcare costs. (Employees pay the rest.)
  • A plan that offers minimum essential coverage. You meet this requirement by offering a comprehensive medical plan.

If you don’t offer coverage or your health plan doesn’t meet the requirements above, you may incur a penalty. Read more about how healthcare reform impacts large employers.

Increase in Penalty for Individuals Without Coverage
Individuals must maintain minimum essential coverage each month or pay a penalty. For 2015, the penalty increases to the greater of $325 for each adult plus $162.50 for each child, up to $975 per family, or 2 percent of household income over the tax filing threshold. Read more about coverage requirements for individuals.