Under the Affordable Care Act, governments, insurers, employers and individuals are given shared responsibility to reform and improve the availability, quality and affordability of health insurance coverage in the United States. The estimator is specifically designed to help you determine if the employer shared responsibility provision (IRC Section 4980H) applies to you and, if it does, will help you determine the maximum amount of the employer shared responsibility payment that could apply to you under either section 4980H(a) or 4980H(b) based on the number of full-time employees that you report.

The provision applies to employers called applicable large employers that employ on average at least 50 full-time employees (including FTEs) during the preceding calendar year. If you are an applicable large employer, you may owe the payment if at least one of your full-time employees receives the premium tax credit because:

  • You don’t offer health coverage to at least 95% your full-time employees (and their dependents) OR
  • You do offer health coverage to at least 95% of your full-time employees (and their dependents), but the offer of coverage doesn’t provide minimum value or is unaffordable to a particular employee, or a full-time employee that was not offered coverage receives the premium tax credit.

Click here for more information on the employer shared responsibility provision, how it applies and what it requires.

As always, please contact your Total Benefit Solutions, Inc health insurance specialists with any questions or concerns at (215)355-2121.