As the federal Affordable Care Act's online health insurance marketplace opened Tuesday for business, many employers are trying to figure out what this means for their employees.
People who don't have health insurance by Jan. 1 will face a tax penalty. Individuals already insured through, for example, their employer or Medicare or Medicaid don't have to do a thing; they're set.
People who are uninsured, underinsured or not receiving health insurance through their employer at this time, however, can shop for a policy at healthcare.gov.
For business owners, however, the timeline and rules are a little different.
Under the ACA, large businesses must provide health insurance for their employees by Jan. 1, 2015, as the government pushed back their compliance deadline by a year.
The law defines "large" business as one with 50 or more full-time employees.
The law also defines "full-time employee" as someone who works 30 or more hours per week.
A "small" business, then, is one with fewer than 50 employees.
The ACA does not require small businesses to provide their employees with health insurance, though it does encourage them to do so through tax credits and a federal online site called the SHOP Exchange, which stands for Small Business Health Options Program.
At a meeting in Dubuque Tuesday, Iowa's insurance commissioner Nick Gerhart explained to a group of more than 50 people, about 20 of whom were small business owners, some of the changes that will go into effect.
"There's a lot of things that have changed, so I think it's critical to get help and advice from somebody," Gerhart said. "A good agent is where I would start, especially in the small business community."
Although large businesses will be required to offer health insurance to their employees, Gerhart said, most already do -- and for good reason.
"In Iowa, I think, it's well over 95 percent, actually, in the 'large' market, that have coverage that's available to their employees, and we talk to those employers. They say, 'Well, we offer that to retain and attract talent,'" Gerhart said.
Some small businesses in Iowa also offer their employees health insurance.
"Most employers that offer insurance, we hear that they're going to continue offering insurance, but, by all means, I think employers across the state are probably going to look at the SHOP exchange as something to at least check to see if it makes sense for their business," Gerhart said.
Critics of the ACA say the mandate for large businesses is resulting in a cut in hours for some employees, whose employers are trying to avoid that 50 full-time employee limit.
Gerhart said that's especially felt in service-industry businesses, which generally see a higher number of part-time employees, such as lawn care, fast food and retail.
"That's outside of our jurisdiction at the Iowa Insurance Division, but we have heard from some employees that are concerned that their hours have been cut," Gerhart said, adding the "50 full-time employees" rule isn't so simple as counting heads.
"It's actually a formula at the IRS," he said, combining the total number of hours worked by all employees -- part-time and full time.
Gerhart recommended business owners who wonder whether they fall into the "large" category check out the calculator through the U.S. Chamber of Commerce HERE.
Cathy Breitbach attending Tuesday afternoon's meeting at Northeast Iowa Community College's Center for Professional Development in Dubuque. She owns three small Dubuque businesses.
"We're busy running our businesses, and I guess I feel the government doesn't even know what's in all those pages (of the ACA)," Breitbach said, "I am hoping to -- in a very quick, informative way -- find out how it affects us small businesses."
She came with concerns she would face rising costs.
"I think, if us small businesses incur any more expenses, we're not going to be around," Breitbach said. "If you've never owned your own small business, who do people think are paying our bills? Nobody pays for our health insurance, nobody gives us a pension. You know, I mean, everything comes out of our pocket."
Gerhart assured small business owners like Breitbach they won't face penalties if they don't or can't offer health insurance to their employees.
Still, Gerhart said, there are many people who go without the added protection.
"In the state of Iowa, we have about 700,000 Iowans that do not have access to employer-based coverage or other minimum-essential coverage, and those folks, as you can imagine, run the gamut on income," he said, adding he thinks some 250,000 of those would qualify for some level of subsidy if they shop through healthcare.gov.
To read Gerhart's open letter about the Affordable Care Act, click HERE.
To visit the federal government's SHOP Exchange for small business owners, click HERE.
To shop for individual health insurance on the federal government's online marketplace, click HERE.
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