74752 Proposed Rules on Health Insurance Reforms and Wellness Programs 112612 (1).pdf ViewDownload
Proposed Rules on Health Insurance.
On Nov. 20, 2012, federal agencies responsible for health care reform released advance copies of three proposed
rules implementing provisions of the Affordable Care Act (ACA). The proposed regulations relate to:
Health insurance market reforms and rate review;
Essential health benefits, actuarial value and accreditation; and
Employer-based wellness programs.
Feb 14, 2013, 7:26 AM
77991 HCR Pay or Play Penalty Identifying Full Time Employees 020713.pdf ViewDownload
Effective Jan. 1, 2014, the Affordable Care Act (ACA) imposes a penalty on large employers that do not offer minimum
essential coverage to “substantially all” full-time employees and dependents. Large employers that do offer coverage
may still be liable for a penalty if the coverage is unaffordable or does not provide minimum value.
Feb 14, 2013, 7:29 AM
HCR Determining Minimum Value of Health Plan Coverage 122712.pdf ViewDownload
Effective for 2014, a large employer may be liable for a penalty under the Affordable Care Act’s (ACA) “pay or play”
rules if any of its full-time employees receives a premium tax credit through a state-based health insurance exchange
(Exchange). A “large employer” is an employer with at least 50 full-time equivalent employees during the
preceding calendar year.
To qualify for the premium tax credit, an individual cannot be eligible for other minimum essential health coverage,
including coverage under an employer-sponsored plan that is affordable to the individual and provides minimum
value. Thus, an individual may receive a premium tax credit if his or her employer’s group health coverage does not provide minimum value.