Common questions (and answers) about the Affordable Care Act law

Some aspects of the Affordable Care Act law remain very confusing, and others are still not completely settled.

But not all concerns are so complicated to resolve. We have collected several common questions, with their answers. And, if you have questions about how the Affordable Care Act will affect you, post a comment below, or email them to us.

When does open enrollment begin for small businesses?

Unlike individuals, small businesses are not limited to buying coverage during a year-end open-enrollment period. They can buy group coverage year-round (when bought before the 15th of the month, the coverage begins on the first day of the next month). However, the Affordable Care Act does create a special end-of-the-year open-enrollment period in the small-group market, from Nov. 15 to Dec. 15, when small businesses can obtain coverage without having to meet the insurer’s normal minimum requirement for how many employees must enroll. Typically, carriers require at least 70 percent of a company’s employees to participate in the plan in order for the business to get the coverage.

Are the SHOP exchanges finally working?

In theory, small businesses can buy insurance coverage either through the small-business health insurance marketplaces — also known as the SHOP exchanges — or they can buy directly from carriers or brokers. Last fall, the federal government, which is operating the marketplaces in about three-quarters of the states put aside the small-business exchanges to focus their efforts on the individual exchanges. Federal officials insist that the SHOP exchanges they run will be fully functional by the time the special open enrollment period begins on November 15.

Can I use an insurance broker to enroll in SHOP?

Yes, in most, if not all, states. In fact, for the moment, given all of technical problems SHOP exchanges have had, using a broker remains the easiest way to enroll in a plan through the exchange.

How do SHOP rates compare to other small group market rates?

When an insurer offers a substantially similar plan both on and off the exchange, there can be no difference in the price. It is unclear whether plans that are not available through the marketplaces will be priced differently.

Instead of offering a health plan, can I use pretax dollars to reimburse my employees for buying an individual policy?

The consensus among lawyers and other experts contacted by the Agenda is that the Internal Revenue Service believes there is no legal way to reimburse employees for buying their own insurance with pretax dollars. It is, however, perfectly legal to make such reimbursements with post-tax dollars.

Can I claim the small-employer tax credit in advance of filing my taxes, as with the subsidies for the individual exchange?

The Affordable Care Act provides low- and (some) middle-income people a tax credit to subsidize coverage when they buy it on the individual exchange, which can be paid in advance directly to the insurance carrier rather than claimed the next year when they file their taxes. However, the small-business tax credit is not similarly “advanceable” — as part of the general business credit, it may only be claimed on a tax return.


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Lawman Benefits Consulting, Inc

P.O. Box 1177
Osprey, FL 34229

Office: 941-966-2228

Direct: 941-661-4069

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