The Affordable Care Act

Health Insurance Responsibilities of Large, Midsize & Small Employers Buying Insurance on the Individual Health Insurance Marketplace and the Small Business Health Options Program

An Employer’s responsibility to offer health insurance under the Affordable Care Act depends on the number of its full time equivalent employees. A business with fewer than 50 full time equivalent employees is not required to offer health insurance; beginning in 2016, a business with 50-99 employees is, and in 2015, a business with more than 100 employees must offer insurance to 70% of its employees, which increases to 95% beginning in 2016. The uninsured can buy insurance in the Individual Health Insurance Marketplace; financial assistance may be available. Small business owners may buy health insurance for their employees through the Small Business Health Options Program (“SHOP”), for which they may receive a tax credit.

Quick Facts: The Health Insurance Marketplace is only open from November 15, 2014 to Februrary 15, 2015 unless individuals have a major change in circumstances, e.g. a job loss, the birth of a child, etc., which qualifies them for a special enrollment period. Information is available online at www.healthcare.gov/quick-guide, operated by the department of Health and Human Services; www.HealthLawAnswers.org, operated by AARP; www.NILC.org, operated by the National Immigration Law Center; www.healthcoverageguide.org, operated by the Small Business Majority; and www.chrt.org, operated by the Center for Healthcare Research and Transformation.

Individuals and the self-employed can call 800-318-2596 for information about buying insurance on the Individual Health Insurance Marketplace; small business owners can call 800-706-7893, M-Fri. 9-7 ET for information about buying insurance on the Small Business Health Options Program. The Small Business Majority provides weekly webinars on Thursdays @ 2:00 P.M.

Date Published: March 1, 2017


Written by: Cooper Levenson, P.A.

Leave a Reply