What is ACA Compliance?
The Affordable Care Act requires organizations to offer affordable insurance with minimum essential coverage and file the corresponding forms by the designated deadlines.
2023 ACA Compliance Changes & Penalties
What is the compliance threshold?
The ACA mandates that large employers, those with over 50 full-time equivalent employees, offer affordable minimum value coverage to “substantially all” full-time employees. “Substantially all” means 95%.
Failure to identify full-time employees and offering coverage or contributing less than the ACA affordability standards may subject your company to penalties.
While an employer may intentionally or unintentionally exclude up to 5% of its employees based on this 95% rule, the employer’s actions cannot be done in a discriminatory fashion.
What are the penalties?
Penalty A: Failure to offer coverage to 95% of full-time employees
Penalty B: Failure to provide affordable, minimum value coverage
What determines affordability?
The amount of household income an eligible individual can contribute toward the cost of coverage in order for coverage to be considered affordable.
What stays the same?
Failure to file forms 1094/1095 with the IRS = $280/form ($3,392,000 maximum)
How Ameriflex can help:
Ameriflex can mitigate the risk by mapping out and executing compliance requirements for you.
Read more about compliance in our Compliance Basics article and our Compliance Services Guide.