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Coverage for Employees, Self-Employers and Small Businesses

Coverage for Employees, Self-Employers, and Small Businesses

Q: I have insurance through my employer. What does the health care law mean for me?
A: If you have health insurance through your employer, nothing will change. However, if you’re uninsured, purchase insurance on your own, or want to explore new options, the marketplace will make it easier for you to shop for plans and see if you are eligible for savings that lower your monthly premiums.

Q: What if I’m losing job-based insurance?
A: If you lose your job and with it your job-based health insurance coverage, you may buy an individual plan through the marketplace. You may also have the option of keeping your health insurance for a limited time through a program called COBRA continuing coverage. COBRA is a federal law that may let you pay to keep you and your family on your employee health insurance for a limited time (usually 18 months) after your employment ends or you otherwise lose coverage.

Q: What if I’m self-employed?
A: If you’re self-employed with no employees, you’re not considered an employer. You can use the individual marketplace to find coverage that meets your needs. You can compare important features of several plans side-by-side, all of them offering a full package of essential health benefits. You can see what your premium, deductible, and out-of-pocket costs will be before you decide to enroll. If you currently have individual insurance – a plan you bought yourself, not the kind you get through an employer – you may be able to change to a marketplace plan.

Q: What do health insurance marketplaces mean for small businesses?
A: A Small Business Health Options Program (SHOP) marketplace is available in each state. SHOP gives small employers and their employees some of the advantages large employers have today, including choices among high quality health plans to meet every budget. Employers who qualify for SHOP must have fewer than 100 employees (states may limit eligibility to employers with 50 or fewer employees for the first two years). Employers must also have an office within the service area of the SHOP, and prove that they’re offering full-time employees SHOP coverage.

Q: Do I have to insure my employees?
A: No employer has to offer coverage. Some large businesses that don’t offer coverage meeting certain standards may have to make a shared responsibility payment.

  • If you have fewer than 50 full-time equivalent (FTE) employees, you are not subject to the Employer Shared Responsibility parts of the law. You may use SHOP to offer coverage for your employees
  • If you have 50 or more FTEs, you may have to make an Employer Shared Responsibility Payment if at least one of your full-time employees gets lower costs on their monthly premiums when buying insurance in the marketplace.

Q: Will my business get tax credits?
A: You may qualify for employer health care tax credits if you have fewer than 25 full-time equivalent (FTE) employees making an average of about $50,000 a year of less. To qualify for the Small Business Health Care Tax Credit, you must pay at least 50 percent of your full-time employee’s premium costs. The credit is available only if you get coverage through the SHOP marketplace. You don’t have to wait until open enrollment to find out if you qualify for the Small Business Health Care Tax Credit. You can find out now by visiting http://www.irs.gov/.

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Mission
To improve and save lives through compassionate quality health care.

Vision
To be the trusted choice for health and wellness.

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Methodist SHINES

Methodist Health System Foundation

P.O. Box 655999 Dallas, Texas 75265-5999  |  1-877-637-4297