Delay for “Pay or Play” Rules

Medium-sized Applicable Large Employers (ALEs) now have until 2016 to comply with the pay or play rules.  The pay or play rules outline penalties that can be imposed on businesses that choose not to offer minimum essential coverages to full-time employees and their dependents that are affordable.

If you’re a business owner and you believe you may qualify for this delay, you must show the following:

  1. You employ at least 50 full-time employees, but fewer than 100 during 2014
  2. Between February 9, 2014 & December 31, 2014 you may not reduce the size of workforce or hours
  3. During coverage maintenance period, you may not eliminate or reduce health coverages

If you changed your plan year after February 9, 2014 to begin on a later calendar date, you are not eligible for the delay.

ALEs have until 2014 until penalties are issued for not offering coverage to at least 95% of Full-time employees; however, to avoid a payment they will need to offer coverage to 70%.  By 2016, 95% of Full-time employees need to be offered coverage.


As always, United Insurance Service is here to help, contact us if you need help understanding how these rules apply to your business.

Final Regulation Issued on the 90-day Waiting Period

On Feb. 20, 2014, the Departments of Labor, Health and Human Services and the Treasury released final regulations on the Affordable Care Act’s 90-day waiting period limit. These regulations generally finalize provisions in proposed regulations issued in March 2013, with minimal changes. At the same time, the Departments released a separate proposed rule regarding a new provision permitting orientation periods under the 90-day waiting period limit.

Continue reading

Transition Policy for Canceled Health Plans

If you received a notice that your health insurance plan is canceled, you are probably wondering what to do next.  With so many changes occurring due to health care reform, you need to know how to obtain coverage.

Continue reading