Have questions about employee benefits,

compliance, and more?

Choosing and implementing insurance for your business can be an overwhelming task. Be prepared and get the facts! Below are a few helpful answers to some common questions. For a more information request an appointment with one of our expert employee benefit specialists.

We bring you day to day reliability as an established leader in Group Benefits.


Do I qualify for a subsidy under the affordable care act?

For 2017 if you or your spouse’s employer offers a plan that meet federal guidelines, and doesn’t cost you more than 9.66% of your annual household income to insure just you, then you do not qualify for a subsidy.

What does the government consider to be a plan that meets federal guidelines?

For 2017 Government qualifications for a health plan require that the plan be at least a bronze plan, and that it doesn’t cost the employee more than 9.66% of their household income to insure just the employee.

Do I have to offer insurance to my employees?

If you employee 50 or more full-time equivalent employees, then you have to offer health insurance that meets the government guidelines.

What is considered a full-time equivalent employee?

Any employee working 30 hours or more is considered a full-time employee.

What happens if an employee receives a subsidy even though I offer a qualified plan?

If this happens you could be subject to an audit, at which point the government will determine if your plan meets all of the ACA guidelines. If it does, the employee will be charged back for any subsidy they received. If your plan doesn’t meet federal guidelines, you will be subject to penalties.

Does it even make sense for me to offer group health insurance?

It depends on the situation. If you have less than 50 full-time employees, you are not required to offer insurance. That being said, you are not barred from doing so. If you offer a plan, you may cover as much of the employee’s premium as you want; or you may even contribute nothing. The downside to offering a plan if you have less than 50 employees, is that they may not be able to receive a subsidy depending on their household income. In many cases, it is a catch twenty-two, whereby offering a health plan may help some of your employees and hurt others

Am I considered a large group?

This is a confusing question as well. According to the Affordable care act, any business the employer has ownership in counts towards the total number of employees. This is called common ownership, and has been the cause of quite a bit of confusion. If the total number of full time employees for all businesses owned is 50 full-time employees or more, then you are considered a large group. It should be noted that the businesses don’t have to be in the same field, any business the employer has ownership in counts towards the total number of employees.

Is my company required to do 6056 reporting?

If you are a large group, you are required to fill out the 6056 reporting. If you are over 250 employees, you will be required to file this electronically.

What are the penalties for not offering insurance?

If your business has more than 50 full-time employees, for the first 30 employees you will be fined nothing. Moving forward you will be fined $2000 annually, per additional employee.

What are the penalties for not having insurance?

In 2017 the penalty for not having insurance is 2.5% of your annual household income, or $695 per adult and $347.50 per child under 18 (maxing out at $2085); whichever is higher.

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