Employee Benefits Compliance, Employer Mandate, Large Employers, Taxes, Fees & Penalties

What Happens If Some Full-time Employees Do Not Have Health Coverage as of January 1, 2015?

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What are the ramifications for employers and for individuals if an individual does not have health coverage as of January 1, 2015?

For individuals, the result is always the same: an individual who does not have “minimum essential coverage” (MEC) as of January 1, 2015, will be subject to the Individual Mandate tax, unless they meet one of the exceptions or qualify for a hardship exemption (see details below). The Individual Mandate is the requirement that individuals obtain health coverage for themselves and their dependents starting January 1, 2014.

For employers, the result will vary depending on whether:

  • the individual is full-time or part-time,
  •  the individual buys health insurance in the Exchange/Marketplace and receives a subsidy,
  •  the employer is a “large” or “small” employer, and
  •  the employer’s plan is a calendar-year or non-calendar-year plan (and if such plan qualifies for a delayed effective date).

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