Small Companies are companies, which have less than 50 employees ,each employee is working more than 30 hours – Small Companies do not have to offer health insurance to their employees and will not pay a penalty.

(Be careful companies which have several locations, for example restaurants and carwashes might be considered as one unit – and therefore have more than 50 employees) If a part-time worker is working more than 30 hours he is considered a full-time worker).

Companies with over 50  full-time employees( employees who work more than 30 hours a week) do have to offer “minimal essential” and “affordable health insurance “to their employees or otherwise pay a penalty .

If an employer is not offering “minimum essential health insurance coverage” , and one employee is getting health insurance through the state exchange than the employer will  pay an annual per employee penalty of $ 2000, of $ 167 per month .

The calculation of penalty is as follow, the employer receive a credit of 30 full-time employees . So the company who has 50 employees has to pay a penalty  for 20 employees . The annual penalty would be $ 40,000 ( 20 x 2000)  or monthly  $ 3333.- ( 20×2000/12)  . Over the total employees calculated would be $ 67 per employee per month. ( 20×2000/(50.12)  – This penalty is far less than what you pay for health insurance per employee in the current market.

An employer’s coverage is considered unaffordable for any full-time employees who, in a given month, enroll in a health plan offered through a State Exchange and are eligible to receive federal premium subsidies . An employee is only eligible for premium subsidies through the state exchange if their required contribution for their employer’s plan is greater than 9.5 % .

If one or more full-time employees receive federal subsidies due to purchase of health insurance through an exchange in a given month, the employer must pay a monthly penalty based on the number of  full-time employees who receive federal subsidies . The annual per employee penalty for not offering affordable health coverage is $ 3000 . To get the monthly penalty is $ 250.- . For the first 30 employees you do not have to pay a penalty. So if you have a company with 50 employees and 3 employees buy health insurance on the state exchange and receive a subsidy , than you have to pay monthly for these employee together $ 750 .

These different calculations of the penalty, plus having a credit of $ 30 employees, is confusing and the best thing is to calculate with your accountant and insurance broker  if it is making sense to offer health insurance, which is tax deductible  or pay the penalty, which is not tax deductible.

Here are the cost sharings for your medicare  benefits in the year 2013.

Monthly Part B Premium  -  $ 104.90 ( some beneficiaries may be subject to higher Part B premiums because of their income )

Part B Deductible:                    $ 147.00

Part A Deductible:                    $ 1,184.00

Daily cost to beneficiary for hospital days 61-90 in a benefit period :    $ 296

Daily cost to beneficiary for hospital days beyond the 90th day in a benefit period: $ 592

Skilled nursing facility daily coinsurance amount after the first 20 days in a benefit period:    $ 148

Confused about Medicare in Santa Monica or the rest of California ? Don’t hesitate to contact Solidhealthinsurance to give you a free  overview of all your options.

This is not the case . The Obamacare  ( the Affordable Care Act ) requires only certain employers to purchase health insurance or else pay tax penalty. Starting January 1 2014, employers with 50 or more full time equivalent (FTE) employees ( on average working more than 30 hours a week)  are required to provide health coverage to full-time employees or else pay a tax penalty.

For small companies, meaning less than 50 employees there is no enforcement that they have to offer health insurance to their employees or pay a penalty. There are tax credits for small companies if they offer health insurance.

Even with the tax penalty, many employers with more than 50 FTE will calculate the cost of not providing health insurance and might find it is more cost-effective to send employees to the public state health exchanges. The penalty for employers might vary between $ 2000 to $ 3000 per employee. The charge starts with the 31 st employee.

It will be interesting to see if employers will reduce their health insurance offering, as the administration work  and health insurance have been permanently increasing in the last decade in Santa Monica and the rest of California.

The health insurance exchange , Covered California, will open October 1st, 2013 and continue enrollment until March 31st, 2014. You must purchase health insurance during this open-enrollment period to obtain coverage in 2014. If you have a life changing event such as loss of job , death of a spouse, divorce or birth of a child, you would be eligible for special enrollment within 60 days of the event.

If you decide not to enroll during this “open-enrollment period”, you will not be guaranteed a health plan will cover you, either through the exchange or the private market. The next open-enrollment period begins in October 2014 for coverage in 2015.

Only certified agent can assist you to buy your health insurance through the exchange, if your current agent is not certified than he cannot sell you insurance plans through Covered CA exchange. The certification for health insurance agent is scheduled to be in August.

Solid Health Insurance Services will make sure to have the certification, so that we can assist all of our clients.

Starting in 2014, insurance companies will be required to sell policies to everyone regardless of current or past health issues, and they will be prohibited from using your health status to determine how much health insurance will cost. The only exception is your smoking status, which will experience an upgrade in your health insurance premium.

This means whether you buy insurance through a health state exchange or a private exchange you cannot be denied coverage or even screened based on a pre-existing medical condition.

This so called “guaranteed issue status” is only valid during the open enrollment period, which will start October 1, 2013 and ends March 31 2014 for the 2014 year.

This will be welcome news for many insured who currently are on Cobra and HIPPA plans, do make a point to contact Solid Health Insurance Services, to see what the  health insurance premium will be if you use the exchanges. The rates for the exchanges will be only available October 1, 2014, let’s see how affordable the health insurance premium will be in Santa Monica.

1) Age, Regional Area and smoking status

2) How much coverage you choose to purchase (you can choose from a Platinum plan down to a Bronze Plan)

3) Whether you qualify for financial assistance such as federal subsidies or tax credits

The state health exchange,  Covered California is the only place where you can use these tax credits to make insurance more affordable.

The Kaiser Family Foundation has a cost-estimate calculator which will help to estimate about how much you will pay per year for your insurance coverage.

For more information how the state health exchange works and to find affordable health insurance visit our website, Solid Health Insurance Services.

Starting in January 2014, most individuals will be required to have health insurance or pay a tax penalty if they don’t. Coverage can include employer-provided insurance, individual health insurance, Medicare or Medicaid.

The tax penalty phases in over three years and becomes increasingly severe. In 2014, the penalty will be 1 percent of annual income or $95, whichever is greater. In comparison to the health insurance premium this tax penalty is very low, and many expert are opposed to the low penalty amount By 2016, the penalty will be 2.5 percent of income or $695. This means that if you do not have coverage in 2014, you will be required to pay a tax penalty when you file your taxes at the end of the year.

The total penalty for the taxable year cannot exceed the national average of the annual premiums of a bronze level health insurance plan, which is offered through the health exchanges. All health insurance carrier will provide proof of coverage to their customers,

Certain individuals are exempt from the requirement to obtain coverage or pay a penalty:

* People with incomes below the threshold required for filing taxes ( in 2012, $ 9750 for a single person and $ 27,100 for a married couple with 2 children

* People who qualify for religious exemptions

*Undocumented immigrants

* People who are incarcerated

* Members of Native American tribes

Especially in Los Angeles, California, where the number of undocumented immigrants is high, it is to be analyzed what can be done to also insure this undocumented immigrants. In Europe these immigrants are responsible for paying the hospital bills and it can be as severe than garnishing their wages and confiscating their cars.

If the health insurance exchange in California should work, than everyone should be a part of it.

Accordingly to the newest quarterly survey conducted by Harris Interactive on behalf of the Chamber of Commerce found that:

• 77% of respondents said the ACA would increase their costs to provide employee coverage;
• 71% said they would face a more difficult time with hiring employees because of the ACA; and
• About one-third said they plan to cut back their workers’ hours as a way to reduce the number of full-time employees on the staff (“On The Money,” The Hill, 4/4).

In addition, 27% of respondents said they plan to stop offering health benefits to employees (“Inside Politics,” Washington Times, 4/4).

 Los Angeles relies heavily on the service industry, such as car washes and restaurants, who currently offer only rarely health insurance for their employees. Many of these companies will have to provide health insurance next year, and as a consequence consumer prices will rise, as the business will have to cover their additional expenses.

The healthcare reform has many good aspects, but to make small business responsible for providing health coverage, might actual slow down our economy.

Confused what the ACA might do to your small business, contact us at Solid Health Insurance Services we will help you to find affordable health insurance for your small business in Los Angeles.

Initially in 2014, SHOP exchanges will limit eligibility to only businesses with up to 50 employees and will expand in 2015 up to 100 employees

The exchange purpose is to simplify the process of finding health insurance for small business, and applying any applicable small business tax credits. Small business will be able to pick a variety of health insurance plans and there is no more participation limitation. Only while buying through the state exchange SHOP will business owner qualify for an up-to  50 % tax credit for the employers contribution.

It is critical that any small business owner keeps informed about the upcoming changes in the health insurance industry,  Solid Health Insurance Services will help you to navigate to the new system of SHOP.