Health Insurance for the Hospitality Industry
Hospitality Insurance Agency specializes in insurance coverage and services for the hospitality industry including nightclubs, bars, gentleman’s clubs, hotels and restaurants. In partnership with Elan Group, we can help you with:
- Complete benefit package design including medical, dental, vision, life, short and long term disability, and voluntary benefits
- Simple IRA and 401(K) retirement plans
- Executive carve out and bonus plans
Hospitality Insurance Agency, in partnership with the Elan Group, can help answer your Health Care Reform questions. Here are just a few to help you understand the upcoming changes:
Employer Coverage Mandate
Beginning in 2015, applicable large employers (ALEs) may face penalties if one or more of their full-time employees obtains a premium tax credit or cost-sharing reduction through an Exchange. The ACA’s employer penalty rules are often referred to as the “pay or play” rules or the employer shared responsibility rules.
An ALE is an employer with, on average, at least 50 full-time employees, including full-time equivalents (FTEs), during the preceding calendar year. An individual may be eligible for a premium tax credit or cost-sharing reduction either because the ALE does not offer health plan coverage or the employer offers coverage that is either not “affordable” or does not provide “minimum value.”
The amount of the pay or play penalty generally depends on whether an employer offers coverage to substantially all full-time employees and their dependents. In general, “substantially all” means 95 percent of an employer’s full-time employees and dependents. However, under a special transition provision for 2015 (and any calendar months during the 2015 plan year that fall in 2016), “substantially all” means 70 percent of an employer’s full-time and employees and dependents.
Penalty for Not Offering Coverage
Once the pay or play rules take effect, an ALE will be subject to a penalty if any of its full-time employees receives a premium tax credit or cost-sharing reduction toward an Exchange plan.
The monthly penalty assessed on ALEs that do not offer coverage to substantially all full-time employees and their dependents will be equal to the number of full-time employees (minus 30) multiplied by 1/12 of $2,000 for any applicable month.
Penalty for Offering Coverage
Employers that do offer coverage to substantially all full-time employees and dependents may still be subject to penalties if at least one full-time employee obtains a premium tax credit or cost-sharing reduction in an Exchange plan because the employer did not offer coverage to all full-time employees, or the employer’s coverage is unaffordable or does not provide minimum value.
The monthly penalty assessed on an ALE for each full-time employee who receives a premium credit will be 1/12 of $3,000 for any applicable month. However, the total penalty for an employer would be limited to the penalty amount for not offering coverage to substantially all full-time employees.
ALEs with 100 or more full-time employees must comply with the pay or play rules starting in 2015. ALEs that have fewer than 100 full-time employees will generally have an additional year, until 2016, to comply with the pay or play rules.