Miscellaneous

What do you need to know about the employer mandate?

What do you need to know about the employer mandate?

All applicable large employers are required to file an annual report that ensures compliance with the employer mandate. The reporting will include information on all employees who were offered and accepted coverage, and the cost of that coverage on a month-by-month basis.

Is the employer mandate based on full time equivalent employees?

Employers will not be required to include the Employer Shared Responsibility payment on any tax return that they file. The employer mandate is based on full-time equivalent employees, not just full-time employees. The fee is based on whether you offer Affordable Health Insurance to your employees that provide minimum value (explained below).

What is the employer mandate under the Affordable Care Act?

Employers are required to offer coverage to at least 95% of full-time employees and dependents. Penalty amount: $2,570 per full-time employee minus the first 30. Coverage offered, but does provide “minimum value” Employers must offer at least one plan that provides “minimum value” (pays at least 60% of the cost of covered services).

What is the penalty for not complying with the employer mandate?

It’s important that employers maintain documentation and records to provide proof of compliance with the employer mandate. Read more about the employer notice process from the Centers for Medicare and Medicaid Services. The penalty is $2,570 per full-time employee, excluding the first 30 employees.

All applicable large employers are required to file an annual report that ensures compliance with the employer mandate. The reporting will include information on all employees who were offered and accepted coverage, and the cost of that coverage on a month-by-month basis.

It’s important that employers maintain documentation and records to provide proof of compliance with the employer mandate. Read more about the employer notice process from the Centers for Medicare and Medicaid Services. The penalty is $2,570 per full-time employee, excluding the first 30 employees.

Employers are required to offer coverage to at least 95% of full-time employees and dependents. Penalty amount: $2,570 per full-time employee minus the first 30. Coverage offered, but does provide “minimum value” Employers must offer at least one plan that provides “minimum value” (pays at least 60% of the cost of covered services).

When do employers ask for your health information?

Requests from your employer. Your employer can ask you for a doctor’s note or other health information if they need the information for sick leave, workers’ compensation, wellness programs, or health insurance.

What do you need to know about healthcare provider credentialing?

Healthcare provider credentialing involves many parties and moving parts. Your doctor — and other healthcare providers — all need to prove they have the education, training, and skills required to properly care for patients.

Can a employer request a medical certification from an employee?

Similarly, although an employer may request a medical certification from an employee who needs to take leave under the Family and Medical Leave Act (FMLA), the employer is entitled only to specific information about the employee’s need for leave — not to a full health screening or medical history.

Is the employer mandate still in effect in Puerto Rico?

Effective July 16, 2014, the employer mandate no longer applies to insured plans issued in the U.S. territories (Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa and the Northern Mariana Islands). A territory may enact a comparable provision under its own law.

How many employees are covered by the employer mandate?

Assume each employer has 1,000 full-time employees who work at least 30 hours per week. Employer 1 currently offers medical coverage to all 1,000 and their dependents. The company is considered to offer coverage since it offers coverage to more than 95% of its full-time employees and their dependents.

How are part time employees determined for the employer mandate?

Part-time employees’ hours are used to determine the number of full-time equivalent employees for purposes of determining whether the employer mandate applies. FTE employees are determined by taking the number of hours worked in a month by part-time employees, or those working fewer than 30 hours per week, and dividing by 120.

Effective July 16, 2014, the employer mandate no longer applies to insured plans issued in the U.S. territories (Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa and the Northern Mariana Islands). A territory may enact a comparable provision under its own law.