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Health Insurance Affordable Care Act

Health Care Marketplace for Small Businesses: FAQ

As a small-business owner, you may be concerned about the way the Affordable Care Act. also known as health care reform. will affect your company.

The law offers incentives that may make it more appealing for you to think about adding, or keeping, your workers' health insurance. Offering insurance, though, also may have drawbacks. Here are some questions to consider if you are an employer with fewer than 50 employees.

I own a supermarket with about 40 employees. Am I required by law to provide health insurance for them? Will I face a penalty if I don't?

No. The employer mandates you've heard about are for businesses with 50 or more employees. Larger employers who don't offer health insurance may have to pay a penalty.

Since your business has fewer than 50 full-time workers, you don't have to pay a penalty if you don't offer them insurance.

I own a restaurant with quite a few part-time workers. How do I determine whether I have the equivalent of 50 full-time workers?

The law considers a full-time employee to be someone who works an average of at least 30 hours a week.

To figure out the number of full-time equivalent employees, add up all the hours paid to part-time employees in a week and divide by 30 (the number of hours considered to be full-time). This will give you the number of full-time equivalent employees the part-time workers represent.

Your mix of full and part-time workers may not lead you to have to offer insurance. If you have the equivalent of 50 or more full-time workers, you still only have to offer insurance to the full-time workers, not part-time workers.

I'd like to consider offering health insurance for my business with fewer than 50 workers. Can I find insurance for them in the new Marketplace being set up in my state?

There are two types of Marketplaces, available in each state. One Marketplace  is for individuals looking for insurance. If you do not offer health insurance through your business, your employees can buy coverage through the individual Marketplace. And they may qualify for a tax credit  to help them cover the cost.

The other Marketplace, called SHOP (Small Business Health Options Program), is for small-business owners like you. Some states work in partnership with the federal government or run their own SHOP. Others rely on the federal government to run the SHOP for their residents through HealthCare.gov. You can log on to HealthCare.gov to find the SHOP for your state. You can compare plans online, apply and enroll on your own or with the help of an insurance agent or broker. You will be able to compare the costs and benefits of the plans in SHOP and then select the plan or plans to offer your workers (employee choice options vary by state). All the plans that are offered in SHOP will use a standard format to explain their coverage and prices. And they will all use plain language to describe their policies.

Through your state's SHOP, you will select the level of coverage you want to offer your employees (bronze, silver, gold, or platinum) and how much money you wish to contribute to the cost of their insurance. If you offer employee choice, your employees will then be able to select from the range of plans that meet the criteria you have set.