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How Employers Can Approach Health Care Reform’s Shared Responsibility Penalty

By Monique Warren on December 5, 2012
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Many employers put off making plans to deal with the employer shared responsibility penalty provision of the 2010 health care reform law until after the November elections.  With President Obama’s re-election and no real possibility of legislative repeal, procrastinating further would be ill-advised.  Employers need to understand now the way the penalty can be triggered in 2014, its potential financial impact for them, and how alternatives to avoid the penalty could affect their businesses. 

Beginning in 2014, the health care reform law requires each employer with 50 or more “full-time” equivalent employees to either – 

  • provide at least a specified minimum level of health coverage that its employees can afford or
  • pay a penalty. 

If minimum essential coverage is not offered to substantially all full-time employees (and dependents) and at least one full-time employee obtains subsidized exchange coverage, the employer must pay an annualized penalty equal to $2,000 multiplied by the number of full-time employees in excess of 30 full-time employees. 

If affordable minimum essential coverage is offered to substantially all full-time employees (and dependents) but at least one full-time employee nevertheless obtains subsidized exchange coverage, the employer must pay an annualized penalty equal to the lesser of – 

  • $3,000 multiplied by the number of full-time employees who decline employer coverage and receive subsidized exchange coverage, or
  • $2,000 multiplied by the total number of full-time employees in excess of 30 full-time employees.

To avoid being blind-sided by unanticipated costs in 2014, employers that have not already done so must strategize now and complete their game-plans early in 2013.  Among other things, an employer must know how to determine whether it has the threshold number of full-time equivalent employees, whether it is offering the minimum level of coverage to all full-time employees and dependents, what its projected health plan costs are, how important its health plan is to attracting and retaining employees and meeting other objectives, the cost of various alternative changes necessary to avoid penalties, what “full-time” means and alternative methods for measuring and classifying workers as full-time or not full-time, and how a full-time employee can qualify for subsidized exchange coverage. 

If you need help understanding and planning for the employer penalty (or any other aspect of the health care reform law that impacts employers), please contact a member of the Jackson Lewis LLP health care reform task force (Monique Warren, Joe Lazzarotti, Lisa deFilippis, Randy Limbeck, Kathy Barrow, Melissa Ostrower, Jay Knight; or, for collective bargaining issues, Kelvin Berens or Eric Simon) or the benefits attorney with whom you normally work.

Photo of Monique Warren Monique Warren

Monique Warren is a principal in the White Plains, New York, office of Jackson Lewis P.C. She counsels employers on employee benefits compliance and administrative matters, represents employers to government agencies, and prepares plan documents and related employee communications.

Monique’s expertise includes health…

Monique Warren is a principal in the White Plains, New York, office of Jackson Lewis P.C. She counsels employers on employee benefits compliance and administrative matters, represents employers to government agencies, and prepares plan documents and related employee communications.

Monique’s expertise includes health and welfare plans as well as retirement plans. She has extensive experience helping plan sponsors navigate COBRA, HIPAA, and other ERISA and Internal Revenue Code provisions and correct compliance issues. A significant part of her practice currently focuses on defending employers in federal investigations of their group health plans as well as assisting government contractors with fulfilling fringe benefit obligations. She also has extensive experience helping retirement plan sponsors comply with ERISA fiduciary requirements and the Code’s qualification requirements and correcting plan errors under the Department of Labor’s and Internal Revenue Service’s voluntary correction programs.

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  • Posted in:
    Health Care and Life Sciences
  • Blog:
    Benefits Law Advisor
  • Organization:
    Jackson Lewis P.C.
  • Article: View Original Source

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