There are important changes happening over the next year for small businesses, including new coverage options for small businesses through the Health Connector. This page will be updated frequently, so check back often or sign up for updates. For any questions not covered here, call Customer Service at 1-877-MA-ENROLL (1-877-623-6765).
Frequently Asked Questions
What does national health reform mean for employers?
National health reform includes new responsibilities and opportunities for employers. The law provides incentives to help make offering health insurance coverage to workers easier and, in some cases, more affordable.
The ACA helps level the playing field for Massachusetts’ employers, setting nationwide standards for benefits and consumer protections that had already been required or commonplace in the Commonwealth.
How does national health reform help Massachusetts small business owners?
The ACA provides additional tools for covering workers, which can help Massachusetts employers ensure that their workforces have the health insurance they need. For example:
- National health reform establishes new tax credits for certain small employers to make it more affordable to cover their employees (eligible employers can achieve even greater savings by using these tax credits in tandem with participating in the Health Connector’s Wellness Track program, which qualifies them for an additional 15 percent premium discount)
- Very low-income employees who cannot afford their employer’s coverage may be newly eligible for MassHealth (Massachusetts’ Medicaid program) without penalties for employers
- The ACA newly offers “one-stop” shopping for medical and dental coverage through the Health Connector
- The ACA invests in initiatives and innovations designed to improve the health care delivery system, which will create a healthier workforce and cost savings for Massachusetts’ employers
Later in 2014, the Health Connector will offer small businesses new ways to offer health insurance to their employees, including options that allow the business to offer a number of plans to employees.
How do I find out if my small business could be eligible for the small business tax credits created by national health reform?
The Affordable Care Act establishes new tax credits for certain small employers to make it more affordable to cover their employees. Eligible employers can achieve even greater savings by using these tax credits in tandem with participating in the Health Connector’s Wellness Track program, which qualifies them for up to an additional 15 percent premium rebate.
Employers can get up to a 50 percent federal tax credit when they buy health insurance through the Health Connector, if they:
- have 25 or fewer full-time employees A full-time employee is an employee who works an average of at least 30 hours per week (so part-time would be less than 30 hours per week). , and
- pay average annual wages below $50,000, and
- pay at least half of the premiums for employee health insurance.
The Health Connector also exclusively offers Wellness Track, a free program offered to eligible employers enrolled in a small business group health plan through the Health Connector. Employers who are not the sole owner and employee of a company and who have fewer than 25 employees total are eligible for the program. Eligible employers who participate may qualify for a Wellness Track rebate of up to 15 percent on their group’s health insurance premium contribution for coverage purchased through the Health Connector.
Will there be new penalties for employers and how do they apply?
The federal law creates new employer penalties. They will start in 2015 and will apply to employers with more than 50 workers only. This policy is referred to as the Shared Responsibility for Employers component of the ACA.
There may be a penalty for some employers that do not offer affordable health insurance coverage to full-time employees. It can be up to be $2,000 per each full‐time worker. The penalty will be triggered should any full-time employee get subsidized insurance from a health insurance Marketplace, like the Health Connector. This happens when a full-time worker, whose household income is under 400 percent of the federal poverty level, is either
- not offered health insurance, or
- is offered self-only health insurance that is unaffordable because it would cost more than 9.5 percent of the household’s income, or
- is offered health insurance that does not meet a minimum value standard A health plan meets this standard if it’s designed to pay at least 60% of the total cost of medical services for a standard population. Starting in 2014, individuals offered employer-sponsored coverage that provides minimum value and that’s affordable won’t be eligible for a premium tax credit. . This means that the plan is designed to pay less than 60 percent of the total health care costs of the benefits it covers
Potential penalties are calculated differently depending on whether the employer offers their full-time workers no coverage, or unaffordable or substandard coverage. Employers that do not offer any coverage can be subject to a penalty of $2,000 per full-time worker.
Employers that offer substandard or unaffordable coverage may be subject to a penalty that will be the lower of the following two options:
- $3,000 for any employee who receives a subsidy through an insurance Marketplace, OR
- $2,000 multiplied by all of the employer’s full‐time employees.
The first 30 workers are excluded towards the calculation of this penalty.
How will the Shared Responsibility for Employers policy in the ACA mesh with the Fair Share Contribution policy in Massachusetts’ health reform law?
Massachusetts health reform (passed in 2006) included a policy that assessed employers with 11 or more full-time-equivalent employees that did not make a “fair and reasonable” contribution towards the health care costs of their workers. Given that national health reform includes its own incentives for employers to offer health insurance to workers, the Patrick Administration opted to streamline and reduce requirements of this nature for Massachusetts employers. As such, Governor Deval Patrick signed a provision in the Fiscal Year 2014 budget that eliminates the Fair Share Contribution policy. The repeal of Fair Share Contribution policy is not expected to affect employer offer rates here in Massachusetts, as employers have been key partners in the success of the Commonwealth’s landmark health reform law and have continued to offer coverage to workers at very high levels, even in the face of the national economic downturn.
The repeal of Fair Share became effective on July 1, 2013. Here are some important updates for Massachusetts employers that may have questions about what this repeal means for any remaining filing or reporting responsibilities:
- Any employer who is sent an FSC Notice to File (NTF) for FSC Quarter 3 (April 1, 2013 – June 30, 2013) needs to complete this filing by the 8/15/13 due date
- Employers who have been sent FSC Notice to File (NTF) letters for prior periods and have not yet filed for any/all of those periods should do so immediately. Enforcement and collection of FSC liability for all periods prior to June 30, 2013 will continue
- No employer needs to file FSC reports with DUA for quarters beginning July 1, 2013 or after
How will the employer-related policies in Massachusetts’ health reform law be reconciled with the implementation of national health reform?
ACA implementation in Massachusetts will result in the easing of some current regulatory requirements for our employers
- Small employers will no longer be subject to an assessment and filing requirements focused on whether or not they offer coverage to their employees (there is no federal “employer responsibility” assessment for employers with 50 or fewer employees, and the Commonwealth’s Fair Share assessment has been eliminated)
- Employers will be required to submit an Employer Health Insurance Responsibility Disclosure (HIRD) form only once a year (some currently submit quarterly). In addition the state has relieved businesses from responsibility for collecting Employee HIRD forms from their workers
- All employers will see a reduction in their current Unemployment Health Insurance contribution
- The ACA allows coverage with higher deductibles and out-of-pocket limits than are currently permissible for satisfying Massachusetts’ individual mandate (the Health Connector has conformed its Minimum Creditable Coverage rules to the federal approach).