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A TRUSTED INDEPENDENT HEALTH INSURANCE GUIDE SINCE 1999.
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Featured

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13 qualifying life events that trigger ACA special enrollment
Outside of open enrollment, a special enrollment period allows you to enroll in an ACA-compliant plan (on or off-exchange) if you experience a qualifying life event.

Latest News & Topics

Latest News & Topics

Featured

Featured
Finalized federal rule reduces total duration of short-term health plans to 4 months
A finalized federal rule will impose new nationwide duration limits on short-term limited duration insurance (STLDI) plans. The rule – which applies to plans sold or issued on or after September 1, 2024 – will limit STLDI plans to three-month terms, and to total duration – including renewals – of no more than four months.
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employer mandate

What is the employer mandate?

What is the employer mandate?

The Affordable Care Act requires employers with 50 or more full-time equivalent employees to provide health coverage to at least 95% of full-time employees and sets a minimum baseline of coverage and affordability. Employers who do not comply face annual penalties if any of their employees end up qualifying for premium tax credits (subsidies) in the Marketplace.

How do the employer mandate penalties work?

There are two types of penalties under the employer mandate. One is for large employers that don’t offer coverage at all, and the other is for large employers that offer coverage that doesn’t provide minimum value and/or isn’t considered affordable.

In both cases, the penalty is only triggered if at least one full-time (30+ hours per week) employee receives a premium tax credit in the marketplace.

The penalty for offering inadequate or unaffordable coverage can never be greater than the penalty for not offering coverage at all.

How much are the employer mandate penalties?

As of 2024, the employer mandate penalties are as follows:1

  • For a large employer that doesn’t offer coverage at all: $2,970 multiplied by 30 less than the total number of full-time employees.
  • For a large employer that offers coverage that isn’t considered affordable and/or doesn’t provide minimum value: $4,460 multiplied by the number of full-time employees who receive a premium tax credit in the marketplace (but this penalty will not exceed the amount of the other penalty, so that will be used instead if it’s less).

These amounts started at $2,000 and $3,000, respectively in 2015. But they are indexed each year by the IRS, and have thus grown over time (see FAQ 55 in this link for details).

Related articles

It's important for the self-employed to know all the ways they can save a few dollars here and there. One obvious place to look is on their tax forms, but one look isn't enough.

Suspect that your employer’s health benefits are subpar? ACA marketplace subsidies could provide relief.

For the self-employed, premiums affect modified adjusted gross income, which in turn affects premiums. But the IRS has a method for addressing this circular situation.

If you’re self-employed, you can generally deduct the full amount you pay in premiums without having to itemize your deduction.

Businesses with 50 or more full-time equivalent (FTE) employees are required to offer comprehensive, affordable health insurance coverage or they risk a penalty.

Footnotes

  1. Revenue Procedure 2023-17. Internal Revenue Service. Accessed January 2024.