Is your employee health plan compliant with the ACA?

Health Law Guide for Business

September 23, 2015

If you have a small business that offers health insurance, make sure your plan complies with Affordable Care Act (ACA) rules that take effect at the end of the year. If your business offers a grandfathered plan or if your health insurance does not comply with the ACA, then you have until Dec. 1, 2015 to enroll in an ACA compliant plan to ensure your coverage meets the terms of the law on Jan. 1, 2016.

Have you received a notice saying your health insurance would be canceled because your plan no longer complies with the ACA?
If so, don’t panic. These notices are being sent because your policy doesn’t include the essential health benefits required by the ACA. Any plan you purchase for 2016 will include those benefits, as well as the certainty that you cannot be turned down for coverage because of pre-existing conditions. In searching for an ACA compliant plan, you may find your health coverage options have also expanded under the ACA and your business may be eligible for new programs or tax credits, or your employees may be eligible for subsidies.

How do I know if I have an ACA compliant plan?
Find out if you are in an ACA compliant health plan by contacting your broker or a Covered California certified insurance broker. You can also check your current coverage to see if it includes the 10 essential health benefits called for by the ACA.

What happens if I don’t renew in an ACA compliant plan?
The ACA does not require businesses with 50 or fewer eligible employees to offer health care coverage. However, it is the law that all lawfully present U.S. residents have health insurance or pay a penalty. Starting in 2016, the penalty for not having health care coverage is a minimum of $695 per adult, or 2.5 percent of your income, whichever is higher.

Still have questions? Check out this fact sheet, and visit our website to get answers to more frequently asked questions about how to make sure your health plan is ACA compliant.

Don’t hesitate to let us know if you have any questions, or would like printed copies of this fact sheet to distribute to any who may find it useful.

The fact sheet is also available in Spanish, which you can find here.

Visit healthlawguideforbusiness.org for more information.



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