10 Questions Every Small Business Owner Should Ask about Health Care Reform

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10 Questions Every Small Business Owner Should Ask about Health Care Reform

 
questions small business health insuranceSmall businesses (companies with less than 50 employees) are largely unaffected by the recently passed health care reform legislation. 

Today, we will answer the 10 most frequently asked questions from small businesses regarding health care reform. 

If we have left out any important FAQs, please ask them in the comment section and we will add them to the post. Thanks!
    1. What is the small business tax credit and how do I know if I am eligible?  Effective January 1, 2010 tax credits are available to qualifying small business that contribute to their employees' health insurance costs. To be eligible for the tax credit, your company must have less than 25 employees and average salaries less than $50,000. To learn more about the small business tax credit, please see "Small Employer Health Care Tax Credit - How Does it Work?"
    2. How do I calculate how many FTE employees I Have? To calculate the number of FTE employees you have, add the number of full-time employees (i.e. those working 40 or more hours per week) with the full-time equivalent part-time employees. The number of full-time equivalent part-time employees is determined by totaling the hours worked by part-time employees and dividing it by 2,080.
    3. Am I required to offer health insurance? No. Small businesses with less than 50 employees are not required to offer health insurance under the new legislation.
    4. Will I be penalized for not offering insurance to my employees? No. There are no tax penalties for companies with less than 50 employees that do not offer insurance.
    5. If I do not offer health insurance, will my employees be required to buy it and will there be any government help? Yes. Beginning January 1, 2014, all individuals must purchase "qualified" health insurance. If they do not, they may be subject to tax penalties of up to $695 per year. Government subsidies will be available to individuals with incomes up to 400% of the poverty line ($88,200 for a family of four) to help pay for individual health insurance.
    6. What is the insurance exchange and how will I be able to use it? By 2014, each state must create an American Health Benefits Exchange and a Small Business Health Options Program Exchange. These exchanges will provide a place where individuals and small businesses can purchase coverage that meets the federal requirements. Small business owners are not required to purchase coverage through the exchanges.
    7. How will health care reform affect my health insurance if I am self employed? Beginning in 2014, self-employed individuals will have access to the small group market and guaranteed-issue individual health insurance policies. Self-employed individuals will still be able to take tax deductions for premiums on their individual 1040. 
    8. What if my business grows to more than 50 full-time equivalent employees? Small business owners with more than 50 employees that do not provide qualified health insurance are required to pay a tax penalty for employees that buy individual insurance and receive a government subsidy. To learn more about how health care reform affects large companies (more than 50 employees), please see "How Health Care Insurance Reform Affects U.S. Employers and their Employees."
    9. Will I be required to change my health plan in 2014? No. The new health care reform bill specifically allows a small business owner to keep their company's current health insurance as a "grandfathered" plan. "Grandfathered" plans will not be subject to new health insurance mandates until the plan is altered. 
    10. Are there new reporting requirements for health benefits for my business? Yes. Beginning in the 2011 tax year, you will be required to report the "aggregate cost" of your employer-sponsored coverage on an employee's W-2. These reported amounts will not be taxed. To learn more about new W-2 reporting requirements, please see "How Health Care Reform Affects Annual W-2 Reporting."
Do you have any additional questions? 
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Note: This should not be taken as legal or tax advice.

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Comments

Under new Bill, Medical insurance is a must, but now you can easily find medical insurance under $40 http://ow.ly/1AqF1


Posted @ Friday, April 06, 2012 4:17 PM by paulyatos5
Orginal Senate bill had 75% single /65% dependent employer paid. This was eliminated, now it states employee no more then 9.5% of gross wage. (No one has answered this question yet , NAHU, Ins. Companies etc.) So based upon 400% FPL and Gross wage - for groups it would mean Employers must pay the other 90.5 % on either single or family coverage..

What will be required of employers contribution for single and family coverage ( as the typical 50% is gone - but have this 9.5% cap in it?)

Posted @ Friday, April 06, 2012 4:17 PM by Dmillington
Thank you for your informative and useful messages! I have an additional question.

I own a small business, there are three employees and me. I am the only officer. I offer and fully pay for high-quality health coverage to all employees. I want to continue to offer coverage so that I and one employee can continue to receive high-quality insurance, but I want the other two employees to go to the public exchange.

My plan is to offer the same high-quality coverage I offer now, but to deduct the maximum amount the insurance company will allow from the employee's pay (usually 50%, according to my agent). I will gross up the pay for my favored employee so he will not see a difference in his paycheck. The other employees will continue to receive they current pay. I think the high deduction of $400 per month will force them to go the the exchange.

Can I do this?

Can a state implement an exchange before 2014? Is this likely?

Thank you

Posted @ Friday, April 06, 2012 4:17 PM by Elsie Brummer
There are no requirements for small employers to contribute a specific percentage to employees health benefits. Some companies may continue to only cover 50% of the premium costs. Beginning in 2014, employees that make less than 400% FPL will have their costs capped at percentages of their income (2%-9.5%). When a company offers health insurance and the percentage paid by the employees costs more than these employees' caps, the employees will purchase subsidized individual health insurance through an exchange and not participate in the group plan.

Note: A company must pay at least 50% of the employees' premiums to receive the small employer tax credit (see the post "Small Employer Health Care Tax Credit - How Does it Work").

Posted @ Friday, April 06, 2012 4:17 PM by Sam Clarke
Sam, thank you for your comment. On the radio today was a comment that large employers will cancel the group coverage because the penalty will be cheaper, which is a given. So your comment that in this bill there are no longer requirements that employers pay 50% of employee portion of the premium. This just confirms that "any" size employer will not offer group coverage, those with less then 50 will have no penalty. Those above 50 will pay the $2000 (-30) penalty rather then Full Blown annual premiums / including self insured.

So the conclusion is Individual Market or Single Payer ( the intention). Which leads to one final comment of a "million" discussions, why would employer then sponsor a HRA in addition to the penalty - other then moral obligation. ( help cover some deductible expense)


Posted @ Friday, April 06, 2012 4:17 PM by Dmillington
The HRA will become a tool for recruitment and retention of employees. Employers will use an HRA to cover all or a percentage of the subsidized individual premiums instead of the cost of group premiums. The HRA will also be used to cover additional benefits tax-free (e.g. dental, vision, etc).

Posted @ Friday, April 06, 2012 4:17 PM by Sam Clarke
Can you please refer me to the language in ERISA guidelines that states with HRAs employers can discriminate reimbursement amounts accoding to class of employee? I need to document this for a skeptical business owner client.

Posted @ Friday, April 06, 2012 4:17 PM by Frank Scotto
Frank, see http://www.zanehra.com/attachm... for a document walking through Employee Classes

Posted @ Friday, April 06, 2012 4:17 PM by Rick Lindquist
I have a question - how do you define a small business? Is it each individual LLC or S-Corp? I have a retail business and I have two different locations. They are completely independent of each other and operate as seperate businesses. Individually, each location is well below the 50-employee limit. However, combined, they exceed 50 employees. Will I have to pay the $2,000 fine?

Posted @ Friday, April 06, 2012 4:18 PM by D-Man
See http://www.zanebenefits.com/bl... for information on the $2,000 fine.

Posted @ Friday, April 06, 2012 4:18 PM by Rick Lindquist
Can an owner of a small partnership receive a "reimbursement" for his (and child's) additional fee for health insurance.
I.E. Wife works for company and receives $800 of health insurance (Wife's payment it $420).
for husband and child to be added, it is another $920 per month.
Can my small business partnership that can not qualify for good health insurance, offer the two owners a $700 monthly stipend to either be self-insured or to go buy some health insurance (such as being added on my wife's policy)?

Posted @ Friday, April 06, 2012 4:19 PM by Rx
Yes. Although, the owner may need to report the reimbursements as taxable income on his or her tax return.

Posted @ Friday, April 06, 2012 4:19 PM by Rick Lindquist
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Disclaimer: The information provided on this website is general in nature and does not apply to any specific U.S. state except where noted. Health insurance regulations differ in each state. See a licensed agent for detailed information on your state. Zane Benefits, Inc. does not sell health insurance.