Tag Archives: healthcare reform

Healthcare Reform in 2015: Employer Responsibilities

Employers in the twenty-teens are dealing with some major changes set in place by the Patient Protection and Affordable Care Act (PPACA) of 2010. This massive healthcare reform has altered the way that employees receive healthcare, and it’s critical for employers to understand what these changes entail. Here are some of the main employer responsibilities associated with the reform so you can ensure that you remain compliant.


Employer Share Responsibility Provisions

As of January 1, 2015, any employer with 50 or more full-time employees will be responsible for offering employees the chance to enroll in an employer-sponsored healthcare plan or the employer may receive a penalty. The catch is that this doesn’t necessarily mean that there has to be 50 full-time employees. Instead, there can be a combination of full-time and part-time employees as long as the hours equal that of 50 full-time employees.

So for example, you could have two part-time employees whose combined hours are equivalent to a one full-time employee. If you are wondering what number of hours constitute as full-time, the IRS states that “a full-time employee is an individual employed on average at least 30 hours of service per week.”


Requirements for Large Employers

Businesses with more than 50 full-time employees are classified as a large employer. When they fall into this category, they must adhere to the PPACA’s guidelines or may be liable for an employer shared responsibility payment. However, smaller businesses with fewer than 50 full-time employees are not required to offer employer-sponsored health coverage. They are exempt and don’t have to worry about any backlash stemming from the PPACA.


Non-compliance Penalties

According to the IRS, an employer can be penalized because of one of the following scenarios:

  • They don’t offer health coverage or offer coverage to fewer than 95% of their full-time employees and the dependents of those employees, and at least one of the full-time employees receives a premium tax credit to help pay for coverage on a marketplace.


  • They offer health coverage to all or at least 95% of their full-time employees, but at least one full-time employee receives a premium tax credit to help pay for coverage on a marketplace.

In terms of specifics, a large employer that fails to offer health insurance coverage will be responsible for paying a $2,000 penalty each year for every full-time employee beyond the first 30 if they have one or more employees who receive subsidized coverage from the marketplace. In the event that en employer does offer insurance, they will be required to pay $3,000 annually for every full-time employee who is offered coverage, but receives a premium credit to buy insurance from the marketplace.

While the PPACA serves multiple purposes, one was to make it meet the increasing demands of employers wanting employer-sponsored health coverage. The problem is that all of the details can be difficult to understand, and some business owners may be unaware of their employer responsibilities. And although it won’t affect smaller business owners, it’s important to stay up-to-date on PPACA regulations and stay compliant.

Photo by Damon Sacks

How the PPACA Affects Payroll

The Patient Protection and Affordable Care Act (PPACA) of 2010 was the biggest healthcare reform since 1965 and has resulted in big changes for businesses. Besides altering the way that employers provide their employees with healthcare, it’s also changed certain aspects of financial record keeping. As a result, it’s important to stay on top of these changes to ensure that your business remains compliant in the future. Here are some specific ways that the PPACA affects payroll.


Medicare Payroll Tax

For individuals earning more than $200,000 annually, there has been an increase in their payroll tax. Although there was a Medicare payroll tax of 1.45 percent in the past, the PPACA has resulted in a new surtax for some employees. This means that high-income earners must now pay 2.35 percent when their wages are higher than $200,000. The interesting thing about this is that the increase in payroll tax doesn’t actually contribute to Medicare, but simply covers the PPACA’s expansion.


Increased Tax on High-Income Earners

While normal Medicare tax on most employees is 2.9 percent, there is now an added 0.9 percent tax on wages exceeding $200,000 for individuals who are single or head of the household and $250,000 for those who are married and filing jointly. This means that these high-income employees now pay a grand total of 3.8 percent. Consequently, you are now responsible for withholding the extra 0.9 percent for qualifying employees.


Health Insurance Coverage Aggregation for W-2 Reporting

Although it won’t impact smaller businesses, the PPACA will affect payroll reporting for employers who file 250 or more W-2 forms each year. Under the new system, employee sponsored health coverage for the following items must be aggregated when filing this volume of forms:

  • Major medical coverage
  • Domestic partner coverage included in gross income
  • Hospital and indemnity or specified illness paid through salary reduction or by employers
  • Health flexible spending accounts in excess of employee’s cafeteria salary reductions for all qualified benefits.

If you charge a COBRA premium, then you must also aggregate:

  • Employee assistance plans providing employer sponsored healthcare coverage
  • Employee sponsored wellness programs
  • On-site medical clinics provided by employers

The amount that you report should cover your portion as an employer and whatever your employees pay for one lump sum.

Regardless of your stance on this healthcare reform, there’s no denying the impact it’s had on business owners and employees. While the changes to payroll aren’t necessarily monumental and primarily impact larger companies, you will still want to be aware of how the PPACA affects payroll taxes and reporting. It’s also important to stay updated on this and similar laws and regulations that can influence your business and the way you handle taxes.