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Key Considerations for Small Businesses Enrolling in the Affordable Care Act

Key Considerations for Small Businesses Enrolling in the Affordable Care Act

December 23, 2023

With the introduction of the Affordable Care Act (ACA), many changes have occurred in the American healthcare system. One impacted sector is small businesses, which face numerous complexities and opportunities regarding health insurance coverage for their employees.

While the ACA poses potential benefits for these businesses, understanding the law and making informed decisions requires careful consideration of several factors. Here are six key considerations for small businesses enrolling in the Affordable Care Act:

1. Size of the Business
The size of a small business plays a significant role in ensuring ACA compliance. Businesses with fewer than 50 full-time employees are not obligated to provide health insurance for their workers. However, opportunities to access group health coverage through the Small Business Health Options Program (SHOP) marketplace are readily available for these businesses. On the other hand, businesses employing 50 or more full-time employees, also called full-time equivalents (FTEs), are mandated to provide medical insurance for their workforce or face monetary penalties. This ACA mandate is known as the employer-shared responsibility provisions.

2. Tax Credits
The ACA allows eligible small businesses to receive tax credits that can significantly lower employee health insurance costs. To be eligible, the company must have less than 25 full-time employees earning an average annual salary of less than $50,000. Furthermore, the business must cover at least 50% of each employee’s health insurance cost. The tax credit may be up to 50% of the employer's contribution towards the employees' premium costs.

3. Insurance Marketplaces
Small businesses can buy health insurance through state or federal health insurance exchanges under the ACA. The Small Business Health Options Program (SHOP) marketplace offers various health plan options for businesses with 1-50 full-time and full-time equivalent (FTE) employees. Businesses must explore these options, compare the costs and benefits, and select the most suitable plan.

4. Employee Wellness Programs
The ACA encourages small businesses to establish employee wellness programs to foster health consciousness. Once the employee wellness program is established, businesses can qualify to obtain incentives through the ACA, such as reductions in health insurance premiums for employees who participate in the wellness program. Some examples of wellness programs include gym memberships, weight-loss counseling, nutrition counseling, programs to reduce smoking, or on-site workplace yoga classes.

5. Reporting
Compliance with the ACA requires businesses to maintain proper records and fulfill annual reporting requirements to the IRS about their healthcare coverage. Detailed employee reports must include provided coverage information and each employee's share of the total allowed benefits costs. This information needs to be given to employees and filed with their taxes. Non-compliance may lead to penalization for the small business and possibly fines.

6. Professional ACA-specific Advice
Given the complexity of these provisions, small businesses should consult with financial and insurance professionals and their tax professionals for information on how the ACA will impact them. A healthcare benefits consultant can also provide insights tailored to specific business contexts, ensuring employee benefits are available that meet ACA requirements.

In conclusion, the ACA offers many opportunities and obligations for small businesses providing health insurance coverage. Understanding the intricacies of the law and making informed decisions significantly impacts the overall business operation and affects its bottom line. Therefore, small businesses must work with professionals to work towards ACA compliance and mitigate penalties under this federal law.


Important Disclosures:

Content in this material is for educational and general information only and not intended to provide specific advice or recommendations for any individual.

All information is believed to be from reliable sources; however, LPL Financial makes no representation as to its completeness or accuracy.

This article was prepared by Fresh Finance.

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