Healthcare Reform Timeline

Healthcare Reform Timeline 2015

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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.