The Affordable Care Act’s Employer Shared Responsibility (ESR) provision — often called “the Employer Mandate” or “Play or Pay” — requires large employers to offer health coverage to their full-time workers or face a potential penalty. Small employers with fewer than 50 full-time and full-time-equivalent employees are exempt.
Play or Pay takes effect January 1, 2015, although special transition relief rules will allow some employers to delay compliance for several months or into 2016.
The concept behind Play or Pay is simple: To play, the employer must offer health coverage to full-time employees that work on average 30 or more hours per week. Employers that fail to offer coverage, or fail to offer adequate coverage, will pay penalties if any full-time employees receive government subsidies to buy individual insurance through an Exchange (Marketplace).
The concept may be simple but the details are complicated. Is the employer a Large Employer and subject to Play or Pay? How are full-time employees defined? What type of coverage is adequate? When must coverage be offered? How are penalties calculated?
This Guide offers step-by-step guidance about the basic Play or Pay rules for employers and more. Download the guide:
As always, your Total Benefit Solutions account manager can sit down with you to review this guide together. Just call us today (215)355-2121 to schedule your client briefing!