Obama Care & Small Business

ginwoman

Well-Known Member
Does anyone know:
1) when does the employer have to take out a group policy to be "legal" with Obamacare?
2) What is the amount of the fine to the employee if they decline group insurance with their employer?
3) When do people start paying this fine? (ie next year at tax time?)
 

officeguy

Well-Known Member
The feds say 50 employees. Individual states may come up with stricter rules (to keep people off the subsidized plans that the states have to chip in for).

For up to 100 employees you can shop through the exchange, but chances are a conventional group plan is going to be the better deal.
 

tommyjo

New Member
Does anyone know:
1) when does the employer have to take out a group policy to be "legal" with Obamacare?
2) What is the amount of the fine to the employee if they decline group insurance with their employer?
3) When do people start paying this fine? (ie next year at tax time?)

Like most things. this is not the place to come for answers to such questions.

Why would you trust any answer you received on a topic so important?

Go to Home | HealthCare.gov or contact a qualified health insurance professional
 

Beta84

They're out to get us
guess no one knows anything? I was thinking about ordering the book called obamacare911.com

if you're looking for responses, it seems most people have a "home life" and instead post while at work. :shrug:

all I really know is the 50 employee thing. I'm sure you could google the answers instead of ordering someone's book where they probably googled the answers and then charged you money to put it together in book form.
 
Does anyone know:
1) when does the employer have to take out a group policy to be "legal" with Obamacare?
2) What is the amount of the fine to the employee if they decline group insurance with their employer?
3) When do people start paying this fine? (ie next year at tax time?)

(1) If you're asking what size employer has to offer a qualifying employer-sponsored plan to its full-time employees (or, likely, be subject to a penalty for not doing so), then it's employers with 50 or more full-time equivalent employees. The number of full-time employees is added to the number of hours worked by non full-time employees divided by 120 (per month). If the result is 50 or more, the employer has to make coverage available to the full-time employees. It gets a little more complicated when we try to figure out what portion (if any) of that coverage the employer has to pay for itself in order to avoid penalties. That depends a great deal on the employer's circumstances (e.g. the household income of respective employees).

(2) I assume you're asking what the penalty is for not maintaining the required coverage - i.e., not getting or being able to get it through work and not getting it any other way (through, e.g., an exchange, Medicare, or Medicaid)? Calculating the penalty is a tad bit complicated, but here are the basics:

(a) It's the greater of:

(i) 2.5% of their household income after taking out their exemption and standard deduction (the percentage is phased in - it's 1% for tax year 2014, 2% for tax year 2015, and 2.5% for later tax years); and

(ii) $695 times the number of people (e.g. the taxpayer, a spouse, dependents) that didn't have the required coverage with the maximum multiplier being 3 (the $695 is also phased in - it's $95 for tax year 2014, $325 for tax year 2015, $695 for tax year 2016, and $695 COLA-ed after that). The dollar amount that is used is cut in half (e.g. $347.50 instead of $695) with regard to people under the age of 18, but the total penalty can still be 3 times the full dollar amount (e.g. $695).​

(b) The penalty is prorated by the month. Generally speaking, they pay it for months during the given year in which they don't have the required coverage - not necessarily for the entire year. They get one 'free' period per year, of up to 3 months without the required coverage, for which they wouldn't have to pay a penalty. But if a period is longer than 3 months, they have to pay the penalty for all of it.

(c) The total penalty for a year is capped at the nationwide average cost of plans that would have provided them with the minimum required coverage, taking into account their family size (i.e. suitable "bronze level" coverage plans).

(d) The don't have to pay a penalty if they don't make enough to have to file an income tax return.

(e) They don't have to pay a penalty if the amount they would have to pay for the required coverage, through their employer if such coverage is available or through an exchange if it is not (i.e. after taking into account what their employer might pay in the former case or the federal subsidy they might qualify for in the latter case), is more than 8% of their household income. That 8% also gets indexed, but I won't go into how.

(f) There are other exceptions, e.g. the recognized religious sect exemption, for individuals not lawfully present, for people determined to have had an applicable hardship.​

(3) For most people, it will be in 2015 when they file their return for the 2014 tax year.
 

ginwoman

Well-Known Member
Good news...if I can call it that when referring to anything regarding this health care train wreck....I am an Amazon Prime member and downloaded a free book (rented it from their library) called "Surviving Obamacare" by Matthew Irons. So far it seems to be easy to read.
 

ginwoman

Well-Known Member
(1) If you're asking what size employer has to offer a qualifying employer-sponsored plan to its full-time employees (or, likely, be subject to a penalty for not doing so), then it's employers with 50 or more full-time equivalent employees. The number of full-time employees is added to the number of hours worked by non full-time employees divided by 120 (per month). If the result is 50 or more, the employer has to make coverage available to the full-time employees. It gets a little more complicated when we try to figure out what portion (if any) of that coverage the employer has to pay for itself in order to avoid penalties. That depends a great deal on the employer's circumstances (e.g. the household income of respective employees).

(2) I assume you're asking what the penalty is for not maintaining the required coverage - i.e., not getting or being able to get it through work and not getting it any other way (through, e.g., an exchange, Medicare, or Medicaid)? Calculating the penalty is a tad bit complicated, but here are the basics:

(a) It's the greater of:

(i) 2.5% of their household income after taking out their exemption and standard deduction (the percentage is phased in - it's 1% for tax year 2014, 2% for tax year 2015, and 2.5% for later tax years); and

(ii) $695 times the number of people (e.g. the taxpayer, a spouse, dependents) that didn't have the required coverage with the maximum multiplier being 3 (the $695 is also phased in - it's $95 for tax year 2014, $325 for tax year 2015, $695 for tax year 2016, and $695 COLA-ed after that). The dollar amount that is used is cut in half (e.g. $347.50 instead of $695) with regard to people under the age of 18, but the total penalty can still be 3 times the full dollar amount (e.g. $695).​

(b) The penalty is prorated by the month. Generally speaking, they pay it for months during the given year in which they don't have the required coverage - not necessarily for the entire year. They get one 'free' period per year, of up to 3 months without the required coverage, for which they wouldn't have to pay a penalty. But if a period is longer than 3 months, they have to pay the penalty for all of it.

(c) The total penalty for a year is capped at the nationwide average cost of plans that would have provided them with the minimum required coverage, taking into account their family size (i.e. suitable "bronze level" coverage plans).

(d) The don't have to pay a penalty if they don't make enough to have to file an income tax return.

(e) They don't have to pay a penalty if the amount they would have to pay for the required coverage, through their employer if such coverage is available or through an exchange if it is not (i.e. after taking into account what their employer might pay in the former case or the federal subsidy they might qualify for in the latter case), is more than 8% of their household income. That 8% also gets indexed, but I won't go into how.

(f) There are other exceptions, e.g. the recognized religious sect exemption, for individuals not lawfully present, for people determined to have had an applicable hardship.​

(3) For most people, it will be in 2015 when they file their return for the 2014 tax year.

Tilted....WOW....you must work in this stuff to know all that. Thanks for the info! ginwoman
 

GURPS

INGSOC
PREMO Member
.... then it's employers with 50 or more full-time equivalent employees. The number of full-time employees is added to the number of hours worked by non full-time employees divided by 120 (per month).


IIRC this has led some business to terminate employes to get below 50
 

ginwoman

Well-Known Member
Well my husband works for a small construction company (under 10 employees) and they seem to be scrambling to get a group policy in force. And I was just wondering why they are so motivated because I thought it was 50 employees before the employer had to start jumping thru hoops.
 
"We have to pass the bill so we can find out what is in it."

That was an incredibly stupid thing (politically) for Nancy Pelosi to say, she teed the ball up for her (and the bill's) critics in perpetuity. But let's be clear about what she actually said so that we might be honest with ourselves about what she really meant. Emphasis added:

But we have to pass the bill so that you can, uh, find out what is in it away from the fog of the controversy.

She said "you" can find out, not "we" can find out as so many people like to suggest with their paraphrasing. And that's a difference that matters. Again, a stupid thing to say, and it still reveals a not-good mindset on her part. But she wasn't suggesting that she didn't know what was in the bill (though she and others that voted on it may not have respectively), she was suggesting that people might like it once they realized and understood what all it would do - e.g., once it was in effect and they could feel its effects. As you know, it's a ginormous piece of legislation with lots of moving (and sometimes not real clear) parts. And there was a lot of horsehit and mistaken information going around about what was or wasn't in the bill - most people couldn't really know what was in the bill because, to do so, they would have to rely on what others (e.g. pundits, advocates, opponents) were saying. And so much of what 'others' were saying was BS, spin, or lie. Most people didn't have the time, or patience, or inclination, to read the whole thing and do all of the cross referencing necessary to get a fair sense of what was really in the bill. It seems to me that she was suggesting that people would get a better sense of what the bill meant by experiencing it rather than by having every single detail explained to them or by trying (and likely failing) to sort out all of the spin. I suspect she'll be right about that, but the general sense they get after experiencing it for a while may not be what she was hoping.

I repeat myself to make it clear that I'm not condoning her comment: It was a dumb thing to say politically AND it revealed a cavalierness - an arrogance - that is disturbing from an elected official with so much power. But she didn't mean what the popular meme would have us believe. She didn't say that she and others in Congress didn't know what was in the bill they were getting ready to pass. That may be true of some of them, but that's not what she suggested in that now infamous statement.
 
Tilted....WOW....you must work in this stuff to know all that. Thanks for the info! ginwoman

You're welcome. No, I don't work on this stuff. But when I set out to understand something, I'm usually pretty thorough in making sure I achieve that result. I was pretty interested in this bill when it was being considered and after it passed, so I put in the effort to get a pretty good general grasp of it. I've forgotten a lot of the details, but I know the big and middle-sized pictures well enough to make it pretty easy to find the specifics that may have slipped my mind.

Here's the scary part though: I left a considerable amount of detail out of that post I made. There are so many aspects of this legislation, and so many of those aspects are agonizingly convoluted.
 

ginwoman

Well-Known Member
You're welcome. No, I don't work on this stuff. But when I set out to understand something, I'm usually pretty thorough in making sure I achieve that result. I was pretty interested in this bill when it was being considered and after it passed, so I put in the effort to get a pretty good general grasp of it. I've forgotten a lot of the details, but I know the big and middle-sized pictures well enough to make it pretty easy to find the specifics that may have slipped my mind.

Here's the scary part though: I left a considerable amount of detail out of that post I made. There are so many aspects of this legislation, and so many of those aspects are agonizingly convoluted.

Tilted do you think there is anything that can be done now to stop the train wreck?
 
Well my husband works for a small construction company (under 10 employees) and they seem to be scrambling to get a group policy in force. And I was just wondering why they are so motivated because I thought it was 50 employees before the employer had to start jumping thru hoops.

Did they not offer a coverage plan before? It may be that they are looking to take advantage of the new credits that the PPACA makes available to small businesses that offer their employees a plan and pay for a certain portion of that plan (IIRC, it's 50% in the general case). As much as the PPACA is likely to cause some problems for larger employers (and more generally, I believe), it could actually be of considerable benefit to some small employers. The credits they can qualify for are not insignificant. The value-added consideration for providing employees with coverage will change for a lot of small businesses; I can see quite a few of them choosing to provide coverage where before they didn't.
 

Larry Gude

Strung Out
She said "you" can find out, not "we" can find out as so many people like to suggest with their paraphrasing. And that's a difference that matters. Again, a stupid thing to say, and it still reveals a not-good mindset on her part. But she wasn't suggesting that she didn't know what was in the bill (though she and others that voted on it may not have respectively), she was suggesting that people might like it once they realized and understood what all it would do - .

Agree and understood. I was making the assumption that everyone knew damn well SHE, her team, her side, knew what was in it. The larger issue, my intended point, was to hone in on the whole transparency thing, the promises that legislators would have time to read stuff before she put it to vote, etc. The whole "Well, I may have intended to give you the impression that we want members to have time to digest stuff so that they may give a considered vote but, what I meant was we're going to pass it any way and you peons simply have to trust me, you'll like it when it comes to law and if you don't, #### you any way."
 
Tilted do you think there is anything that can be done now to stop the train wreck?

I apologize for equivocating, but: No.

In theory, sure, it's possible that things could happen and we get out from under this thing. In reality though, those things seem extremely unlikely - at least in the near term. And the longer we go with this, the more of a mess it would leave even if we (collectively, politically) decided that we should try to undo it.
 

ginwoman

Well-Known Member
Did they not offer a coverage plan before? It may be that they are looking to take advantage of the new credits that the PPACA makes available to small businesses that offer their employees a plan and pay for a certain portion of that plan (IIRC, it's 50% in the general case). As much as the PPACA is likely to cause some problems for larger employers (and more generally, I believe), it could actually be of considerable benefit to some small employers. The credits they can qualify for are not insignificant. The value-added consideration for providing employees with coverage will change for a lot of small businesses; I can see quite a few of them choosing to provide coverage where before they didn't.

I think this is exactly what's happening.
 
Agree and understood. I was making the assumption that everyone knew damn well SHE, her team, her side, knew what was in it. The larger issue, my intended point, was to hone in on the whole transparency thing, the promises that legislators would have time to read stuff before she put it to vote, etc. The whole "Well, I may have intended to give you the impression that we want members to have time to digest stuff so that they may give a considered vote but, what I meant was we're going to pass it any way and you peons simply have to trust me, you'll like it when it comes to law and if you don't, #### you any way."

Fair enough. I think that's, more of less, what she was saying - whether she'd admit it, or put it that way, or not. But I also think that a lot of people have convinced themselves that she was admitting that they themselves didn't know what was in the bill.
 
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