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Healthcare reform: What you need to know

The Affordable Care Act (ACA), passed in 2010, requires most Americans to buy health insurance. Here’s what it means for you and your company.

ACA for companies with 51 or more employees

As defined by the ACA:

  • A large business has an average of at least 100 full-time employees 
  • Mid-sized companies have 51-99 full-time employees and equivalents

Both of these groups are affected by the ACA. 

Shared responsibility

The ACA helps ensure that the U.S. healthcare system shares responsibility for medical costs and payments. Everyone — from the government to individuals to doctors — plays a role in making this framework possible. 

Businesses with 51 or more employees must assume shared responsibility within the following guidelines. 

Employers: 

  • Are required to provide notice to new employees of their health insurance options within the first 90 days of employment, including coverage through Marketplaces and a description of how the employee may contact them for assistance 
  • With 100 or more full-time employees that don’t offer health insurance coverage must pay $2,000 for every full-time employee (not including the first 30 employees) who obtains premium tax credits for purchasing health coverage insurance through a Marketplace 
  • That offer unaffordable coverage or coverage that doesn’t cover at least 60 percent of costs will pay $3,000 for any employee that receives a tax credit in a Marketplace and up to $2,000 for every full-time employee 
  • With 50-99 full-time employees and equivalents that don’t offer health insurance coverage will have to pay $2,000 for every full-time employee (not including the first 30 employees) who obtains premium tax credits for purchasing health coverage insurance through a Marketplace 
  • That offer unaffordable coverage or coverage that doesn’t cover at least 60 percent of costs will pay $3,000 for any employee that receives a tax credit in a Marketplace and up to $2,000 for every full-time employee


Marketplaces

These organizations are set up to create a market for buying health insurance. Marketplaces offer a choice of different health plans and provide information to help consumers better understand their options. 

There are two types of Marketplaces: public and private, which primarily serve individuals buying insurance and businesses with less than 100 full-time employees. 

Penalties

If a business employs: 

  • 100 or more full-time employees or equivalents, penalties will vary according to various healthcare regulations 
  • 51-99 full-time employees or equivalents, penalties will vary according to various healthcare regulations 

View a flow chart explaining the penalty process.

Tax credits

 Large group employers aren’t eligible for tax credits under the ACA.

Related information

Learn more about Geisinger Health Plan.

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