Employer Shared Responsibility – Mandate Provisions

• IRS Employer Mandate Penalty Calculator

Health Care Reform includes the employer mandate – shared responsibility mandate provisions, which require applicable large employers  (IRS Website to determine if you are an ALE) to offer health coverage to full-time employees and their dependents. Those that do not offer coverage might be subject to the employer shared responsibility payment.

I’ll grant you, this can be quite confusing.

1. These provisions apply to applicable large employers, which includes tax-exempt and federal, state, local and Indian tribal government employers. You’re an applicable large employer if you have 50 or more full-time employees, including full-time equivalents.
2. ARPA new rules?
   ACA non – compliance is at risk ^{Benefit Pro} *
3. If you have fewer than 50 full-time employees, including full-time equivalents, you are not an applicable large employer and are generally not subject to these  provisions. However, you are subject to the rules for large employers if you have fewer than 50 employees, but are a member of an ownership group that has 50 or more full-time equivalent employees,
4. You are subject to the payment if any employee receives the premium tax credit from Covered CA and any one these conditions apply. Your organization:

failed to offer coverage to full-time employees and their dependents

offered coverage that was not affordable

offered coverage that did not provide a minimum level of coverage – Bronze

5. You do not report or include an employer shared responsibility payment with any information return you file.

6. Some of the provisions of the Affordable Care Act only affect your organization if it’s an applicable large employer. An ALE is generally one with 50 or more full-time employees, including full-time equivalent employees.   The vast majority of employers will fall below the ALE threshold number of employees and, therefore, will not be subject to the employer shared responsibility provisions.

   • Applicable large employers have annual reporting responsibilities. You will need to provide the IRS and employees information returns concerning whether and what health insurance you offered to your full-time employees.
   • If you’re an applicable large employer that provides self-insured health coverage to your employees, you must file an annual return reporting certain information for each employee you cover.
   • ALEs must either offer minimum essential coverage that is affordable and that provides minimum value to their full-time employees and their dependents, or potentially make an employer shared responsibility payment to the IRS.
   • Learn more about the employer shared responsibility provision.
   • You may be required to report the value of the health insurance coverage you provided to each employee on their Form W-2.
   • If you’re an applicable large employer with exactly 50 employees, you can purchase affordable insurance through the Small Business Health Options Program (SHOP).  Or directly with an Insurance Company, no charge for our services.   See button above or below to get a quote.

     For more information, see

7. Wikipedia on Employer Mandate  *

8.  Affordable Care Act Tax Provisions for Employers

9. ACA 101 Toolkit 2023 Edition
10. ACA’s Employer Mandate: IRS announces higher penalties for noncompliance

#Penalty for not providing Health Insurance –
Minimum Essential Coverage (MEC) is
$2,000/employee

Basically the penalty for not providing  Minimum Essential Coverage (MEC) is $2,000/employee.

The penalty if coverage is not affordable 9.83% or does not provide minimum value – Bronze Plan is $3k/employee. The details get quite confusing… so follow the links in the right hand column and below to see how it would apply to your group, situation, what you are offering and if any of your employees apply to Covered CA for subsidies.   An Employer only has  to offer affordable coverage – which is less than 9.86% of income for employee coverage and 60% AV  Bronze Plan –^{§4980 H (a)  (b)}  to avoid the penalty^.

Learn More⇒

• Penalty letters to start going out July 15th, 2020 ACA Times *
•  CNBC News 3.11.2015.  *
• IRS Penalty Calculator
• CA has an individual penalty for your employees, even there there are less than 50 employees!
• SHRM explanation for 2021

The IRS is taking the responsibility of enforcing the ACA  ^{ACA Times} * 

How Coverage You Offer (or Don’t Offer) May Mean an Employer Shared Responsibility Payment for Your Organization

Under the Affordable Care Act, certain employers, based on workforce size – called applicable large employers – are subject to the employer shared responsibility provisions. The vast majority of employers fall below the workforce size threshold and, therefore, are not subject to the employer shared responsibility provisions.

If you are an employer that is subject to the employer shared responsibility provisions, you may choose either to offer affordable minimum essential coverage that provides minimum value to your full-time employees and their dependents, or to potentially owe an  employer shared responsibility payment to the IRS.  Many employers already offer coverage that is sufficient to avoid owing a payment.

If your organization is an applicable large employer, and you choose not to offer affordable minimum essential coverage that provides minimum value to your full-time employees and their dependents, you may be subject to one of two potential employer shared responsibility payments.

More specifically, you may need to make an employer shared responsibility payment to the IRS if you are an applicable large employer and either of these circumstances applies for 2015:

• You offered minimum essential coverage to fewer than 70 percent of your full-time employees and their dependents, and at least one full-time employee enrolled in coverage through the Health Insurance Marketplace [Covered CA]  and received the premium tax credit.
• You offered minimum essential coverage to at least 70 percent of your full-time employees and their dependents, but at least one full-time employee enrolled in coverage through the Health Insurance Marketplace [Covered CA] and received the premium tax credit.  A full-time employee could receive the premium tax credit because the coverage that was offered was not affordable, did not provide minimum value, or was not offered to the full-time employee.

For both of these circumstances, the 70 percent threshold changes to 95 percent after 2015.

The terms “affordable” and “minimum value” have specific meanings under the Affordable Care Act that are explained in questions 19 and 20 on the employer shared responsibility provision questions and answers page on IRS.gov/aca.  Transition relief for offers of coverage to dependents for 2015 is described in question 33 on the same page.

For more information on the information reporting responsibilities that apply to applicable large employers see IRS’s Questions and Answers on Reporting of Offers of Health Insurance Coverage by Employers.

Enforcement

On April 7, 2017 TIGTA issued its, “Assessment of the Efforts to Implement the Employer Mandate under the Affordable Care Act.” In this report, TIGT explained that the IRS has developed an ACA Compliance Validation (ACV) System. It will be used to identify potentially non-compliant Applicable Large Employers and calculate the “A” penalty under the Employer Mandate. The IRS has been developing the ACV system since July 2015 with a scheduled completion date of January 2017. However, “the implementation of the ACV System has been delayed to May 2017.”

The report states that once the systems are in place, the IRS will be able to mass identify noncompliant employers. This will allow the IRS to send notices to noncompliant employers for any and all reporting years.

This means that time is up for employers who were delaying. The current lack of IRS notices for noncompliance with the Employer Mandate does not imply that the IRS does not intend to enforce the Employer Mandate. The IRS will come knocking, they are just running behind schedule. ^{freedom care benefits.com}

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