Blue Access for Employers

Group Health Plan Changes

You'll notice changes to the health plans you offer your employees, such as:

No pre-existing condition waiting period

Prior health issues won't limit your employees' health coverage.

90-day waiting period

The waiting period you set before your workers can join your group health plan can't be longer than 90 days.

Nearly all U.S. citizens and
lawfully present residents must
have health insurance or pay a penalty.

Wellness Incentive Programs

If you offer a wellness incentive program based on:

Health improvements

The top reward can rise up to 30% of the cost of health plan coverage.

Stopping or lowering tobacco use

Rewards can rise up to 50% of the cost of health plan coverage.

Employer Shared Responsibility (ESR) Rules

All large employers should know about the ESR penalty that starts in 2015.

Starting in 2015, your large business may face a penalty if you:

  • Don't offer minimum essential coverage to your full-time workers
  • Offer coverage to your full-time employees but it doesn't have minimum value (covers 60% of employee health care costs)
  • Offer coverage to your full-time workers but it isn't affordable (workers pay more than 9.5% of their income for the lowest-cost, self-only coverage)

However, you may avoid this penalty if you:

  • Have between 50 and 99 full-time employees and meet certain ACA conditions
  • Offer coverage to 70% of your full-time employees (and dependents) in 2015*
  • Offer coverage to 95% of your full-time employees (and dependents) in 2016*

*This rule applies whether you intentionally — or unintentionally — don’t offer coverage. Employers won’t avoid the penalty for offering inadequate coverage if any of the full-time employees, including those who aren’t offered coverage at all, receive a premium tax credit or cost-sharing subsidy for purchasing coverage through the Health Insurance Marketplace.

Since this is an overview, detailed information on this
topic — and more — is available.