Small Business Insurance Services Inc. is a brokerage firm that has no allegiance to any insurance company. Our agents are also multi state licensed. We will shop all major carriers for you so you always get thebest plan at the lowest price. There are many ways for consumers to purchase health insurance. However the best way is to use an experienced broker, most especially since it costs nothing extra to do so.

Call us directly at (630) 674 1551. If you are outside of Illinois call us toll free at (866) 724 7123 for a free no obligation telephone consultation from one of our licensed brokers. Or, click the application image below to submit your group’s census so we can prepare quotes for your business.

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Small and large employer obligations under the Patient Protection & Affordable Care Act (Obamacare)

Employers with 100 or more FTE – Full Time Equivalent – employees are required to offer “affordable health insurance” (employee’s share of the annual premium for self-only coverage is no greater than 9.5% of annual household income) to all of their Full Time employees and their dependent children (first 30 Full Time employees are excluded) or pay a non tax deductible “Employer Shared Responsibility” payment to the IRS.

This does not include spouses in the definition of “dependents.” Therefore, employers do not have to extend health insurance to an employee’s spouse. In addition, the PPACA “Obamacare” does not require that coverage offered to dependent children be “affordable” or subsidized at the same level as employee coverage.

To comply with reform, the coverage that employers offer their employees must be considered “affordable.” The IRS says coverage is “affordable” for an employee (under an employer-sponsored plan) if the employee’s premium cost for employee-only coverage does not exceed 9.5% of the employee’s household income.”

Click here to determine how many ‘Full Time Equivalent’ employees you have.

Employers with 50 to 100 FTE – Full Time Equivalent – employees are required to offer affordable health insurance to all their Full Time employees and their dependents (children under 26) or pay a monthly non tax deductible “Employer Shared Responsibility” payment to IRS for all but 30 of their Full Time Equivalent employees.

This does not include spouses in the definition of “dependents.” Therefore, employers do not have to extend health insurance to an employee’s spouse. In addition, the PPACA “Obamacare” does not require that coverage offered to dependent children be “affordable” or subsidized at the same level as employee coverage.

To comply with reform, the coverage that employers offer their employees must be considered “affordable.” The IRS says coverage is “affordable” for an employee (under an employer-sponsored plan) if the employee’s premium cost for employee-only coverage does not exceed 9.5% of the employee’s household income.”

Click here to determine how many ‘Full Time Equivalent’ employees you have.

The “Employer Shared Responsibility” payment is triggered and assessed in one of two ways:

1.) $2,000 per employee penalty to employers that do not offer affordable, qualified health insurance to their Full Time Equivalent employees and their dependent children. This does not include spouses in the definition of “dependents.” Therefore, employers do not have to extend health insurance to an employee’s spouse. In addition, the PPACA “Obamacare” does not require that coverage offered to dependent children be “affordable” or subsidized at the same level as employee coverage.

To comply with reform, the coverage that employers offer their employees must be considered “affordable.” The IRS says coverage is “affordable” for an employee (under an employer-sponsored plan) if the employee’s premium cost for employee-only coverage does not exceed 9.5% of the employee’s household income.”

2.) $3,000 per employee penalty to employers that do offer health insurance but that health insurance is deemed either not ‘affordable’ or not a ‘qualified health plan’ and one or more Full Time employee buys health insurance on the exchange and receives an APTC – Advance Premium Tax Credit – (subsidy). In this scenario the employer would be assessed a $3,000 penalty for each employee who received a subsidy.

If an employee’€™s share of the premium for employer-provided coverage would cost the employee more than 9.5% of that employee’€™s annual household income, the coverage is not considered affordable for that employee. Because employers generally will not know their employee’s household incomes, employers can take advantage of one or more of the three affordability safe harbors set forth in the final regulations that are based on information the employer will have available, such as the employee’€™s Form W-2 wages or the employee’€™s rate of pay. If an employer meets the requirements of any of these safe harbors, the offer of coverage will be deemed affordable for purposes of the Employer Shared Responsibility provisions regardless of whether it was affordable to the employee for purposes of the premium tax credit.
The three affordability safe harbors are (1) the Form W-2 wages safe harbor, (2) the rate of pay safe harbor, and (3) the federal poverty line safe harbor. These safe harbors are all optional. An employer may use one or more of the safe harbors only if the employer offers its full-time employees and their dependents the opportunity to enroll in minimum essential coverage under an eligible employer-sponsored plan that provides minimum value for the self-only coverage offered to the employee. An employer may choose to use one or more of the safe harbors for all of its employees or for any reasonable category of employees, provided it does so on a uniform and consistent basis for all employees in a category. If an employer offers multiple healthcare coverage options, the affordability test applies to the lowest-cost self-only option available to the employee that also meets the minimum value requirement.
The Form W-2 wages safe harbor generally is based on the amount of wages paid to the employee that are reported in Box 1 of that employee’s Form W-2. The rate of pay safe harbor generally is based on the employee’s rate of pay at the beginning of the coverage period, with adjustments permitted, for an hourly employee, if the rate of pay is decreased (but not if the rate of pay is increased). The federal poverty line safe harbor generally treats coverage as affordable if the employee contribution for the year does not exceed 9.5% of the federal poverty line for a single individual for the applicable calendar year. The  final regulations provide additional information on these affordability safe harbors.
How does an employer know whether the coverage it offers provides minimum value?
A plan provides minimum value if it covers at least 60 percent of the total allowed cost of benefits that are expected to be incurred under the plan. The Department of Health and Human Services (HHS) and the IRS have produced a  minimum value calculator. By entering certain information about the plan, such as deductibles and co-pays, into the calculator employers can get a determination as to whether the plan provides minimum value. Additionally, on May 3, 2013, Treasury and the IRS issued proposed regulations regarding the other methods available to determine minimum value.
If an employer offers health coverage that is affordable and that provides minimum value to its full-time employees and offers health coverage to the dependents of those employees, will it be subject to an Employer Shared Responsibility payment if some of its employees purchase health insurance through a Marketplace or if some of its employees enroll in Medicare or Medicaid?
No. An applicable large employer will not be subject to an Employer Shared Responsibility payment solely because one, some, or all of its employees purchase health insurance coverage through a Marketplace or enroll in Medicare or Medicaid. An employer will not be liable for an Employer Shared Responsibility payment unless at least one full-time employee receives a premium tax credit. In general, an employee will not be eligible for a premium tax credit if the employer has offered that employee health coverage that is affordable and that provides minimum value, even if that employee rejects the offer of coverage and instead enrolls in coverage through a Marketplace or enrolls in Medicare or Medicaid. If no full-time employee receives a premium tax credit, the employer will not be subject to an Employer Shared Responsibility payment.
If an employer offers health coverage that is affordable and that provides minimum value to its full-time employees and offers health coverage to the dependents of those employees, will it be subject to an Employer Shared Responsibility payment if an employee’s spouse purchases health insurance through a Marketplace, or if a spouse enrolls in Medicare or Medicaid?
No. To avoid a potential Employer Shared Responsibility payment an applicable large employer must offer health coverage that is affordable and provides minimum value to its full-time employees and must offer health coverage to the dependents of those employees. For this purpose, a spouse is not a dependent. An applicable large employer will not be subject to an Employer Shared Responsibility payment solely because it does not offer health coverage to an employee’s spouse or if the spouse purchases health insurance coverage through a Marketplace or enrolls in Medicare or Medicaid. An employer will not be liable for an Employer Shared Responsibility payment unless a full-time employee receives a premium tax credit. If no full-time employee receives a premium tax credit, the employer will not be subject to an Employer Shared Responsibility payment. Thus, even if an employee’s spouse receives a premium tax credit, the employer will not be subject to an Employer Shared Responsibility payment.
If an applicable large employer offers health coverage that is affordable and that provides minimum value to a full-time employee’s spouse, the spouse will not be eligible for the premium tax credit.  For more information about eligibility for the premium tax credit, see our  final regulations and  questions and answers.

All penalties are collected by the Internal Revenue Service and enforced by the Department of the U.S. Treasury.

Under the PPACA – Patient Protection and Affordable Care Act – employer group plans now must offer an annual open enrollment period which begins November 15th and ends December 15th of each calendar year.

 Group health insurance carriers represented by HealthInsuranceMentors.com

 

BCBSIL

 

2016 BCBSIL Small Group Health Insurance Plan Brochures

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