The “employer mandate” is a requirement that all businesses with 50 or more full time equivalent employees provide health insurance to at least 95% of their full-time employees and dependents up to the age of 26, or pay a fee by 2016. Spouses do not count as dependents so coverage does not have to be offered to them. Employers must offer coverage but employees do not have to accept. Employees who work 30 hours a week or accumulate 130 hours a month qualify as full time employees. Coverage offered to employees must be considered affordable, it should not exceed 9.5% of the employee household income. Companies with 100 or more full-time employees must insure 70% of their employees, with this number increasing to 95% by 2016.
Fact: For plan years beginning in 2015 the penalty is $2000 for each full time employee, minus the first 80 employees.
Fact: For plan years beginning in 2016 and beyond, the employers can exclude 30 employees from the penalty calculation.
Fact: If only a few employees end up with unaffordable coverage or if that coverage doesn’t meet minimum value standards, the penalty is $3000 per full time employee who received cost assistance charged monthly.
Fact: As long as the employer has a waiting period of 90 days or less they are abiding by the law and don’t have to pay a fee.
Fact: Close to 96% of employers are small businesses and have less than 50 full time employees. This makes them exempt from the employer responsibility provisions.
| Full Time Equivalent Count | Employer Size under ACA | 2015 Plan Year | 2016 Plan Year and Beyond |
| 1-49 | Small | Penalty does not Apply | Penalty does not Apply |
| 50-99 | Mid | Penalty does not Apply | Must offer coverage to 95% of full time ee’s and deps |
| 100+ | Large | Must offer coverage to 70% of full time ee’s | Must offer coverage to 95% of full time ee’s |
| 200+ | Large+ | Must auto-enroll full time new hires and provide an opt-out |
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