- Tribal Leaders
- AI/AN Individuals
- Tribal Employers
- Tribal Health Directors
- Contact Us & Mailing List
In 2015, large employers must offer minimum essential coverage to full-time employees and their dependents under an eligible employer-sponsored plan, that is affordable, and that provides minimum value. Dependent coverage must be offered for children under age 26, but does not include spouses, foster children, or stepchildren.
An individual can meet the minimum essential coverage (MEC) requirement through an eligible employer-sponsored plan. An eligible employer-sponsored plan means a group health plan or group health insurance coverage offered by an employer to an employee in any of these categories:
An employer’s plan will be considered affordable if the employee only contribution towards the premium does not exceed 9.5% of an employee’s household income. If an employer is unable to determine an employee’s household income, an employer may be able to rely upon the following affordability safe harbors at the end of the tax year to avoid tax liability:
An employer may only use a safe harbor if it offers its full-time employees and their dependents the opportunity to enroll in minimum essential coverage under an eligible employer-sponsored plan that provides minimum value with respect to the self-only coverage offered to the employee.
An employer’s plan has to cover at least 60% of the total allowed cost of benefits that are expected to be incurred under the plan. There are four methods an employer can use to determine minimum value:
Through conformance with the requirements for a level of metal coverage (bronze, silver, gold or platinum) defined at 45 CFR 156.140(b) if the plan is in the small group market.
Click here [insert link to employer survey] to fill out an easy employer survey to determine your responsibility and find out if you are a large or small employer.