You Work for a Large Business: The ACA and Large Employers (50 or More Employees)

What is a Large Employer?

If a business has 50 or more full time equivalent employees, it is considered a “large employer” by the ACA. This applies to all employers—private businesses, churches, non-profit groups, and government.

In addition, if a person owns several small companies, the employees in the different companies can be added together. If the total number of employees is 50 or more, the person is a large employer.

How Does the ACA Affect Large Employers?

Under the ACA, large employers do not have to offer health insurance to full time employees. However, they have to pay a fine, called employer responsibility fees, if:

These fines are for 2014 and will be increased each year after, based on inflation. Small businesses with 49 or fewer full time equivalent employees are not considered “large.” Small businesses do not have to pay any fines. The fines also do not apply to large employers with grandfathered health plans.

How do I Know if My Health Plan is Grandfathered?

You could have a grandfathered health plan if:

  1. The health plan was created on or before March 23, 2010 (the day President Obama signed the ACA into law)
  2. The health plan has not made any big changes to premiums or benefits

Most health plans from large employers are grandfathered.

It is important to know whether or not your health plan is grandfathered because grandfathered plans have to follow certain parts of the ACA. To find out more about grandfathered health plans, click here.

To find out if you have a grandfathered health plan:

What if I Like My Insurance?

If you have insurance through your job and you like it, you can keep it. You do not need to change your insurance, or get your insurance through the Health Insurance Marketplace. You will not need to pay any fines or fees.

What If I Don’t Like My Insurance?

With most insurance that you get through your job, your employer pays a part of your premium. If you don’t like your insurance, you can choose a health plan from the Health Insurance Marketplace.

However, your employer does not have to help pay for your premium if you get insurance from the Marketplace. Also, if the insurance you get through your job is affordable, you will not get lower premiums or out-of-pocket costs on the Marketplace. Insurance is considered “affordable” if:

If you do not qualify for lower costs in the Marketplace, and your employer does not pay part of your premiums on the Marketplace, it may be cheaper to keep the insurance you get from your job. However, you could still choose to get insurance from the Marketplace.

For more information about the Health Insurance Marketplace, click here.

What if my Employer is Not Doing What it is Supposed to?

If your employer is not following the ACA, you can report them to the Department of Labor’s Occupational Safety and Health Administration. A fact sheet explaining how to report ACA violations can be found here: http://www.osha.gov/Publications/whistleblower/OSHAFS-3641.pdf

The ACA protects people who report violations. This is called whistleblower protections. The ACA also protects people who receive tax credits through the Marketplace (which would force their employer to pay fines).

Under the ACA, the employer cannot fire the employee, stop their insurance coverage, or in any way retaliate against their employee.

Where Can I Get More Information?

This government website has brief information about job-based insurance and the ACA: https://www.healthcare.gov/what-if-i-have-job-based-health-insurance

This government website has ACA information for people who are large employers: https://www.healthcare.gov/what-do-large-business-owners-need-to-know

A nice summary about the ACA provisions affecting large employers by the LexisNexis Community: http://www.lexisnexis.com/community/labor-employment-law/blogs/lab-emp-alerts/archive/2013/03/22/the-affordable-care-act-what-employers-need-to-do-now-to-plan-for-2014.aspx

To find out more about whistleblower protections, go to: http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=NEWS_RELEASES&p_id=23673