Health Insurance Strategies

Beginning in 2014 the principal part of the Patient Protection and Affordable Care Act, the health insurance requirement, will go into effect.  On January 1st of next year Americans will be required to obtain health insurance from an employer provided plan, or from an exchange or pay a tax/penalty.  Business owners with more than 50 employees will be faced with a similar question; to either provide health insurance or facing a $2000.00 penalty/tax per employee.  (For help in determining your full time equivalent employees as defined under the Affordable Care Act click here). 

Small Business Tax Credit

When deciding if you should offer health insurance there are a variety of things to consider.  Some companies have decided to get out of the health insurance game altogether.  Beginning 2014 these employers will offer a stipend allowing employees to go out and choose their own level of coverage.   The idea is that employees are better consumers and will choose better individual solutions for themselves while companies can limit their exposure to unpredictable swings in health insurance costs.  Another thing to consider is the recruiting and retention of employees.  In many professions offering health insurance coverage is a given while in others it is almost non-existent.  When formulating a strategy for 2014 keep in mind what your competitors are doing. 

Employers Under 50 Employees:

If you have determined that you will be under 50 employees and therefore not subject to the tax/penalty there are still a few things to consider.  Take a look at your employee count.  If you have fewer than 25 employees you may qualify for a tax credit.  Estimate the costs of providing health insurance, any tax credits and other factors to estimate your costs with each scenario.  Keep in mind your personal cost of non- compliance under the individual mandate. 

Employers close to 50 Employees:

For those just under 50 employees there will be the temptation to remain below that number. Remember that just because you are subject to the overall tax the first 30 employees still remain tax exempt.  The marginal cost of the 51^st employee is $42,000 not $102,000.

Over 50 Employees:

For employers that do not offer health insurance with a significant number of employees over 50 the coming year is causing increasing trepidation.  Many business owners are looking to see if their competitors will be passing on costs to consumers or trying one of the many strategies to lowers their costs under the Affordable Care Act.  Temporary employees are being considered more frequently as the temporary employees are counted under the temporary employer’s number of employees for the tax/penalty.  Another strategy has been to increase the number of employees and cut hours per employee.  For example a large restaurant chain signaled that they were planning on making as many of their part time employees truly part time as defined by the ACA.  Reclassifying employees as part time was accomplished by restricting the number of hours a part time employee can work to fewer than 30 hours per week.  Another time honored route to avoid payroll taxes, workers’ compensation and the like is to try and turn employees into independent contractors.  The Affordable Care Act is another reason some businesses will be looking at classifying people as 1099 independent contractors.   Enclosed is a link to the State of Oregon’s rules on independent contractors. http://www.oregon.gov/IC/pages/05-qanda02.aspx  If you go this route review your plan with someone like a CPA or attorney as there are a variety of pitfalls.  For example, the Internal Revenue Service, Oregon Employment Department and the Oregon Department of Revenue do not completely agree on the definition of an independent contractor. Other businesses are looking at breaking up their entities into groups smaller than 50 employees.   The Affordable Care Act has provisions to treat multiple businesses as one entity.  Structuring your businesses in such a manner that will not be considered as combinable is something you should review with an expert in this arena.  If you are considering this option here are links to the IRS website on controlled groups for you and your attorney and/or CPA to review.

Applicability to the PPACA - http://www.irs.gov/pub/irs-drop/n-11-36.pdf

Guidance on controlled groups-  http://www.irs.gov/pub/irs-tege/epchd704.pdf 

 A twist on independent contractors and non-combinable entities is outsourcing employees to another organization to keep your number of core employees closer to 50. Outsourcing non-core functions – from HR to accounting to shipping is easier than ever.

The Affordable Care Act is a complicated piece of legislation.  Review your options.  Put estimated price tags on each option. Evaluate what other are doing or ask your trade association. Doing so now will help avoid a scramble in the final quarter of 2013.

Arin J. Carmack

VP of Risk Management