What is the employer threshold for the Affordable Care Act?
Asked by: Elwin Funk | Last update: September 5, 2025Score: 4.2/5 (65 votes)
What is the ACA employer mandate threshold?
Employer mandate overview
It applies to employers with 50* or more full-time employees, and/or full-time equivalents (FTEs).
What is the minimum employee count for ACA?
Small business owners with fewer than 50 full-time employees are not required to offer health care coverage to their employees. However, you should know that if a small business with fewer than 50 full-time employees does offer coverage, then that coverage must comply with the requirements of the ACA.
What is the minimum value requirement for the ACA?
An employer-sponsored plan provides minimum value if it covers at least 60 percent of the total allowed cost of benefits that are expected to be incurred under the plan.
What are the ACA requirements for employers in 2024?
Employers must report employee insurance information with the California Franchise Tax Board (FTB) once per year. Information should be submitted to the state using federal Forms 1094-C, 1095-C, and 1095-B. Organizations must also distribute copies to employees.
Affordable Care Act (ACA) Requirements for Employers [Overview]
Does the ACA apply to all employers?
The ACA employer mandate requires ALEs to offer at least 95% of their full-time workers and their dependents affordable health insurance that meets MEC and provides minimum value. If they don't, they may be subject to employer mandate penalties in the form of shared responsibility payments.
What is the 9.5% rule for ACA?
The federal poverty line safe harbor generally treats coverage as affordable for a month if the employee required contribution for the month does not exceed 9.5 percent, adjusted annually, of the federal poverty line for a single individual for the applicable calendar year, divided by 12.
What is one requirement of the Affordable Care Act?
The ACA requires all qualified health benefits plans to cover essential health benefits, including those offered through the Marketplaces and those offered in the individual and small group markets off-exchange.
What determines ACA eligibility?
Under the Affordable Care Act (ACA), Medicaid coverage is extended to nearly all nonelderly adults with incomes at or below 138% of the federal poverty level (FPL) (about $23,556 for a family of three in 2022) in the 42 states (including DC) that opted to expand as of March 2023.
What is the ACA threshold for 2025?
The IRS updated its affordability threshold for the 2025 tax year to 9.02%.
How is ACA affordability threshold calculated?
Take the employee's lowest hourly rate for the month and multiply the number by 130, the minimum total of hours a worker must provide to be classified as a full-time employee under the ACA. Take the product of that calculation and multiply it by 9.02% for 2025.
What is the ACA employer mandate 2025?
Generally requires applicable large employers to offer minimum essential coverage that is affordable and provides minimum value to all full-time employees (and their children to age 26) to avoid potential penalties.
What is the ACA 30 hour rule?
If an employee is credited with an average of 30 hours per week or more during the Standard Measurement Period, the employee would be eligible for benefits for the upcoming plan year.
Can I refuse health insurance from my employer and get Obamacare?
Obamacare is available to everyone, whether or not their employers offer insurance. From a practical standpoint, though, there are financial consequences to doing this. Often, an employer subsidizes part or all of their employees' coverage.
What is the ACA threshold for 2024?
However, in accordance with the newly announced affordability percentage for 2024 (8.39%), an employee would need to make at least $28,605.48 per year ($2,400/8.39%) for the $200 monthly employee contribution for self-only coverage to be considered affordable.
What is the 80 20 rule for ACA?
The 80/20 Rule generally requires insurance companies to spend at least 80% of the money they take in from premiums on health care costs and quality improvement activities. The other 20% can go to administrative, overhead, and marketing costs.
What is the ACA 50 employee threshold?
If you have 50 or more full-time employees, including full-time equivalent employees, you are an applicable full-time employer and need to issue statements to employees and file an annual information return reporting whether and what health insurance you offered employees.
How to determine if an employee is ACA eligible?
The predefined period is known as the "measurement period" or ACA lookback period. If the employee's average hours per week are 30 or higher, that employee is considered full-time for purposes of the ACA (regardless of HR full- or part-time status).
Who is exempt from ACA?
Hardship exemptions are available for those who cannot afford to pay for health insurance or for whom health insurance would exceed 8.16 percent of their gross household income.
What is the 20 employee threshold?
If you have 20 or more employees: You are covered by the laws that prohibit discrimination based on race, color, religion, sex (including pregnancy), national origin, age (40 or older), disability and genetic information (including family medical history).
What happens if I underestimate my income for Obamacare in 2024?
For the 2024 tax year, if you underestimated your income and received a larger tax credit than you were eligible for, you must repay the difference between the amount of premium tax credit you received and the amount you were eligible for.
How do I know if I qualify for the Affordable Care Act?
Must live in the United States. Must be a U.S. citizen or national (or be lawfully present). Learn about eligible immigration statuses. Cannot be incarcerated in prison or jail.