Employer Provided Health Insurance Offer and Coverage

A summary of business provisions


See below for a point-by-point summary of the new laws and rules that businesses need to follow under the ACA. If you still need help, our interactive step-by-step guides lead you through ACA provisions.


Click to access The Summary of Provisions for Small Businesses guide..

TY 2014 Changes

  • 2010 - 2013Credit up to 35% for employers and 25% for tax-exempt employers
  • 2014 and futureCredit up to 50% for employers and 35% for tax-exempt employersMust purchase coverage through SHOP MarketplaceCredit can be claimed for two consecutive years onlyAnnual cost of living adjustment

TY 2015 Changes (Optional for 2014)

  • Employers with 50 or more full-time employees are required to file Form 1095-C with employee and IRS
  • Includes information about whether employer offered qualifying health coverage to employee, spouse and dependents for some or all months during the year
  • Form 1095-C is used to determine:Whether employer shared responsibility provision applies (beginning in 2015),Whether individual shared responsibility payment applies, andEligibility of employees for premium tax credit


Small Business Healthcare Credit

  • Available to small businesses that offer insurance (Form 8941)Less than or equal to 25 employees with an average salary of less than or equal to $50,000Employer must cover at least 50% of the premium
  • Tax credit for small employers, including tax-exempt employers
  • Help with cost of providing health care coverage for low and moderate income workers
  • To encourage employers to offer first-time coverage and maintain existing coverage for employees


Employee Shared Responsibility Provision


Employer Mandate

  • Businesses with 100 or more full-time employees must offer insurance or face a penalty beginning on 1/1/15
  • Businesses with 50-99 full-time employees not be subject to employer mandate until 1/1/16
  • Businesses with fewer than 50 full-time employees are exempt
  • Applicable Large Employers (ALEs) mustOffer health coverage to their full-time employees and their dependents, orBe subject to a penalty (generally, $2,000 per year for every employee starting with the 31st employee)