When the affordability regulations for employer-sponsored insurance coverage were passed, they did not take the cost of dependent coverage into account. If your spouse’s employer offers him/her minimum essential health insurance coverage that costs less than 9.5% of your annual household income, then the coverage is deemed affordable. If the employer also offers spousal coverage, then you would be ineligible for Advanced Premium Tax Credit (APTC) or a subsidy on Nevada Health Link.
If your spouse’s employer does not offer spouse coverage then you could come to Nevada Health Link and apply for a subsidy. All large group plans are required to offer dependent coverage, so your children would be ineligible for Advanced Premium Tax Credit through Nevada Health Link. There may be cheaper plans available than the employer-provided dependent coverage, but the children will not qualify for a subsidy. If the employer’s plan did not offer dependent care then the children could get subsidized coverage through Nevada Health Link.
In 2015, Nevada Health Link will be powered by HealthCare.gov. HealthCare.gov provides small businesses with a SHOP (Small Business Health Options Program) that will let you easily compare many Qualified Health Plans (QHPs) offered by private insurance companies. Everything you need to choose the plans that are right for your business and employees will be available, and you can continue to work with your broker or agent to enroll in plans if you wish. HealthCare.gov offers the same plans you’re used to, but with more choice and more advantages, including better coverage and lower-cost deductibles and premiums.
Businesses with fewer than 50 full-time equivalent employees (FTEs) are exempt from the requirements to offer coverage, and there are no penalties for those businesses if they don’t offer coverage. But businesses with 50 or more FTEs may have to pay a penalty if they do not offer affordable minimum essential coverage (MEC) to their full-time employees.
Employers with 2-50 full time employees will be able to use the HealthCare.gov SHOP to select which plans their employees can enroll in. Employees will log on and choose the plan they would like from the plans the employer selected. Employers will receive one easy-to-read bill for all of their employees. Learn more about how the SHOP works here.
No, as an employer you’ll choose the level of coverage you want to contribute and which QHP your employees can choose. You decide which plan you want to offer and how much you want to contribute to the plan first, then your employees log on and sign up for the plan you selected.
All of the plans offered through Nevada Health link can insure employees’ dependents. As an employer, you will decide if you want to offer spousal and dependent coverage or let your employees decide if they want to purchase coverage for their families through Nevada Health Link’s individual marketplace.
How does an employer qualify and apply for tax credits if they provide health insurance coverage for their employees?
To qualify for tax credits an employer must:
- have 25 employees or fewer
- have average firm wages of $50,000/year or less
- provide health insurance coverage for employees (the employer must contribute a minimum of 50% of the cost of their employees’ coverage)
- file the appropriate tax returns (Form 8941; Line 44f of Form 990-T for exempt organizations) with their tax preparer
Tax credits are available now. Businesses may apply for the previous years’ credits for which they qualify.
No, a business does not need to have an established Section 125 plan to participate in our SHOP. Here are the eligibility requirements for SHOP participation:
- 50 or fewer full-time employees in 2014
- SHOP will be opened up to employers with 100 or fewer full-time employees in 2016
- Tax credits will be available in 2014 and 2015 for employers with 25 or fewer employees and average company wages less than $50,000/year (excluding the owner(s) and owner(s)’ families).
Only employers with more than 50 Full Time Equivalent employees will be subject to penalties. These employers must offer a health insurance package that meets the Federal Essential Health Benefits (EHBs) and does not cost their employees (not including dependents) more than 9.5% of their household’s annual salary.
The penalty for employers with more than 50 FTEs who do not offer the coverage as outlined above will be $2,000 x (FTEs-30). For example, if an employer had 51 full time employees and did not offer coverage that meets the requirements, the employer would have to pay a penalty of $42,000 ($2,000 x 21 = $42,000).
If I have more than 50 employees and have a plan that meets the EHBs and does not cost employees more than 9.5% of their salary, what happens if they don’t elect the plan and come to Nevada Health Link?
If an employer provides affordable minimum essential coverage (MEC) for their employees, the employees are not eligible for Advanced Premium Tax Credit (APTC) on the HealthCare.gov individual online marketplace. During the enrollment process, the employee will have to:
- attest that they do not have access to affordable MEC; and
- list their employer, employer’s address and employer’s telephone number
The employer will not be penalized for an employee who does not elect to participate in an employer-sponsored health insurance plan that is affordable and meets MEC.
Nevada Health Link is now powered by HealthCare.gov. All of the plans offered are still certified by Nevada Health Link, but enrollment will now take place through HealthCare.gov. Nevada Health Link is still the only health insurance resource that can provide individuals federal tax credits and subsidies to help cover the cost of insurance. Plus, Nevada still provides its citizens with many ways to obtain in-person assistance throughout the State.
Nevada Health Link is still its own website, by Nevadans, for Nevadans, but it is now powered by HealthCare.gov. This means that eligibility and enrollment will take place through HealthCare.gov. All of the plans are still State-certified, and NevadaHealthLink.com still houses a lot of information and resources specific to Nevadans. Plus, Nevada still provides its citizens with many ways to obtain in-person assistance throughout the State.