Affordable Health
Care Act …
Avoiding Penalties
in 2015
Dave Villar, President
Pacific Coast Benefits LLC,
Dave Villar is the President of
Pacific Coast Benefits LLC. He was a
founder and partner of PDI Insurance
Services. Dave is an active mem-
ber of the National Association of
Health Underwriters and a member
of the Anthem Blue Cross Agent
Advisory Council. He has specialized
in Employee Benefit Planning for
businesses since 1987. To find out
more about Pacific Coast Benefits and
upcoming Healthcare Reform Seminars,
visit pacbenins.com or call
(408) 847-1000.
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In 2015, employers will also need
he new year brings with it new
to navigate new regulations and
challenges and changes for
penalties as well. As of January 1,
Americans interacting with the
2015, employers with more than 100
Affordable Care Act. Both individuals
full-time employees must offer qualified
and business will see changes in 2015
health insurance to 70% of their
to ACA regulations and penalties.
employees or face a penalty. In 2016,
Earlier this month Covered California
the threshold drops to 50 employ-
announced it is stepping up messaging
ees and 95%. Most large employers
about the rising penalties for not
have been planning for this event
having health insurance, encouraging
and already have a qualified plan in
Californians without coverage to
place, however many have not and will
sign up for coverage and avoid the
face a potential Shared Responsibility
tax penalties. In 2015, the “Shared
Penalty. The penalty for not offering
Responsibility Penalty,” the penalty
qualified, affordable health insurance
for not having health insurance has
is $2,000 per
increased signifi-
employee after
cantly from 2014.
“Consumers must enroll soon
the 80th employ-
In 2015, a family
to insure they don’t miss the
ee in 2015 and
of four earning
window of opportunity for buying
after the 30th
$70,000 per year
subsidized health coverage this
employee in
could pay up to
year and to avoid steep penalties
2016. In addi-
$1,000 in penal-
taking effect for not having
tion to the pen-
ties if they remain
coverage in 2015”
alty, new report-
uninsured in 2015,
ing requirements
a dramatic increase
begin this year
from last year. The
that must be filed by February of 2016.
same family of four will likely see that
To prepare for this, larger employers
penalty rise to $2,085 if they continue
are encouraged to “clean up” their
to remain uninsured into the end of next
record keeping and documentation
year. Unlike in years past, the purchase
practices. Large employers will be
of Individual Health Coverage is limited
required to report names, addresses,
to a specific time frame know as Open
and tax identification numbers for all
Enrollment. This year, Open Enrollment
participating and non-participating
ended March 1st and many insurers
employees. A draft release of this
including Covered California closed
requirement and the tax forms them-
the application process on February
selves (1094-C and 1095-C) can be
15th. Peter Lee, the Executive Director
found on the IRS website. These two
of Covered California, issued a state-
forms will be used to report data to
ment last month regarding this Open
the IRS regarding offers of insurance
Enrollment Season. “We continue to
to eligible employees and the costs
see strong interest in enrolling in cover-
associated with the offer.
age as Open Enrollment continues, but
Now more than ever good advice
there are still hundreds of thousands
and direction from a qualified insurance
of Californians who need to sign
professional is invaluable. If you have
up. Consumers must enroll soon to
questions regarding the Affordable
insure they don’t miss the window of
Care Act and its impact on your family
opportunity for buying subsidized health
or business, please feel free to contact
coverage this year and to avoid steep
us. Pacific Coast Benefits is here to
penalties taking effect for not having
help navigate the Affordable Care Act.
coverage in 2015.”
G M H T O D A Y M A G A Z I N E
MARCH / APRIL 2015
gmhtoday.com