Affordable Care Act Compliance Calculator
Since the inception of the Affordable Care Act (ACA), its ever-changing rules and regulations have surpassed 20,000 pages.
Are you in compliance with them?
Number of ACA full-time and full-time equivalent employees employed on average during the previous calendar year:
As a small employer you may be subject to employee-coverage rules and should be using the standard measurement period to determine your full-time employees.
As an applicable large employer (ALE), you are subject to the employer mandate and should be measuring your employees to determine whether they are ACA full-time, using the look-back measurement method or the monthly measurement method.
How many full-time employees do you have in a month?
Do you offer minimum essential coverage to 95% of your full-time employees and their dependents?
Congratulations! You are on your way to ACA compliance because you offer minimum essential health coverage to at least 95% of your full-time employees and their dependents.
If you do not offer health insurance to at least 95% of your full-time employees and their dependents, and one or more of your employees qualifies for a subsidy, opting for coverage through the exchange, you could be fined $2,320 per year for the total number of full-time employees – not counting the first 30 – for the months when the employee(s) received a premium subsidy. This fine would be assessed on a monthly basis.
Possible monthly fine: $0
Does your plan pay at least 60% of covered health costs?
Congratulations! Your plan covers 60% of covered health costs and is one step closer to meeting the employer mandate requirements.
If your plan does not pay 60% of covered health costs, and one or more of your employees qualifies for a subsidy and opts for coverage through the exchange, you could be fined $3,480 for each month for each employee who received a subsidy. This penalty would not exceed the fine for not offering minimum essential coverage to at least 95% of employees and their dependents.
Possible monthly fine: $0
Must any employee pay more than 9.5% (as annually adjusted) of their income for employee-only coverage?
It looks like you have employees who could be eligible to receive subsidies if they decide to buy coverage through the exchange, if they pay more than 9.5% (as annually adjusted) of their household income, as calculated using one of the three affordability safe harbors allowed by the IRS. As the employer, you could face a $3,480 penalty for each employee receiving subsidies for coverage. This penalty would not exceed the fine for not having offered minimum essential coverage to 95% of full-time employees.
You offer affordable health insurance. Coverage under an employer-sponsored plan is considered affordable if an employee’s required contribution to the plan for employee-only coverage does not exceed 9.5% (as annually adjusted) of the employee’s household income, as calculated using one of the three affordability safe harbors allowed by the IRS.
Total number of full-time employees: 0
Number of employees receiving subsidies:
Potential penalties for employers who offer insurance that does not meet the affordability requirement could cost:
Possible monthly fine: $0