Understanding
Health Care Reform

Blue Cross of Northeastern Pennsylvania
Can Help You Prepare

An Affordable Care Act Timeline
Blue Cross of Northeastern Pennsylvania is dedicated to providing the information you need to make the best choices for your company, your employees
and your bottom line.

Know when the ACA will impact your business

The Affordable Care Act (ACA), also known as Health Care Reform, is a federal law that has made sweeping changes to health insurance. This timeline gives you a year by year look at key parts of the ACA—so that you can better understand how and when the ACA will impact your business. You will get useful information about the ACA and what it means for you and your employees. You can find additional resources to check throughout the timeline and along the right side of the page.

We encourage you to check back often for updates.

2015 Provisions

Employer Responsibility Requirement (“Pay or Play”)

The Employer Shared Responsibility Requirement was originally planned to go into effect in 2014 but was delayed by the Department of Treasury until 2015. On February 11, 2014, the U.S. Department of Treasury and the Internal Revenue Service (IRS) released final regulations on the Employer Responsibility Requirement. For more information, you can also check out The Department of Treasury’s summary of the final regulation and the IRS questions and answers.

This requirement imposes a penalty on employers with 50 or more full-time employees (or equivalents) who do not offer affordable health coverage that provides a minimum level of coverage to its full-time employees. The penalty is imposed when at least one of their employees receives a tax credit or subsidy on the Federally Facilitated Marketplace (FFM). Generally, employees who receive a tax credit or subsidy are between 100% and 400% of the Federal Poverty Level (FPL).

Employers with fewer than 50 full-time employees (or full-time equivalents) are not subject to the Employer Shared Responsibility Requirement.

In 2015, if an employer meets the 50 full-time employee threshold, the employer generally will only be responsible for an Employer Shared Responsibility payment if one of the following applies:

  • The employer does not offer health coverage or offers coverage to less than 95% of its full-time employees, AND at least one of the full-time employees receives a premium tax credit on the FFM
  • The employer offers health coverage to at least 95% of its full-time employees, BUT at least one full-time employee receives a premium tax credit on the FFM, because the coverage offered to the employee was either not affordable according to Health Care Reform standards or did not provide minimum value

These provisions apply to employers that have at least 50 full-time employees (employees who work at least 30 hours a week on average) or full-time equivalents (hours worked in a month by part-time employees, divided by 120). Seasonal workers are included in calculating the number of employees if they work for an employer for more than 120 days per year.

Employers will determine each year, based on their current number of employees, whether they will be considered a large employer for the next year.  For example, if an employer has at least 50 full-time employees (including full-time equivalents) for 2014, it will be considered a large employer for 2015. 

For details on how to calculate the number of employees and the penalty associated with this provision, please visit the IRS website on this topic. 

What is BCNEPA doing to help?
  • Shop our store at BlueCrossNEPAStore.com for a variety of affordable health insurance plans and the security and peace of mind that comes with the Blue Cross® Blue Shield® family—which has been part of your community for 75 years!
  • For details on how to calculate the number of employees and the penalty associated with this provision, please visit the IRS website on this topic.
  • For help determining what, if any, penalty you will need to pay, check out this employer penalty calculator on the U.S. Chamber of Commerce website.

Health Insurance Reporting Requirement

For health coverage provided during the calendar year beginning 2014, anyone who provides health insurance for someone else (including employers) needs to file a “return” provided by the Secretary of Treasury related to health coverage.

  • Anyone who provides minimum essential coverage to an individual or as part of a group plan during a calendar year will need to file a “return” including whether or not coverage was obtained through a marketplace.
  • Large employers (50+ employees) will need to submit a return to the Secretary including certification of whether affordable and minimum essential coverage was offered to employees.
What can we do to help?
  • We recommend checking back for updates on this site; as the Secretary of Treasury will issue regulations, we will update our content.
  • You can also read more on this topic at www.healthcare.gov.
  • We advise you to file the form for health coverage provided during the 2014 calendar year.