what percentage is an employer required to pay for health insurance?

Small and Big Business Wellness Insurance: Country & Federal Roles

Updated ix/12/2018

Over the by decade or more, state and federal laws generally required that health coverage providers accept small employers applying for coverage. With groups such as small businesses, the insurer has determined a premium cost based on risk factors balanced over the entire group, using full general information on members of the group, such as historic period or gender. Small-scale businesses ofttimes pay more for employee wellness benefits because they don't have the buying ability of large employers. On average, pocket-sized businesses paid about eight to 18 percent more than than big firms for the aforementioned wellness insurance policy. Health coverage providers may charge different premiums to small employers based on the manufacture of the employer or on the employer's prior health claims. As both workers and small employers experience the financial squeeze, fewer are able to afford to offer, or buy, health insurance coverage. States most often review or corroborate policies that are offered directly to consumers or to pocket-size employers. Most states have had laws that require country-licensed wellness insuring organizations to provide coverage to pocket-size employers that want it, with some limitation on the rates that can be charged (east.g., restrictions on how premiums tin can vary based on age and wellness condition).

The Patient Protection and Affordable Care Act or ACA (P.L. 111-148) assisted and afflicted small and big businesses in a number of ways.

Small Business Snapshot: Showtime in 2014, small businesses have been able to participate in small-scale concern health options programs or Shop exchanges. These programs include new country-based health insurance purchasing pools or CO-OPs (in about half of the states) where small businesses are able to puddle together to buy insurance. Small businesses are defined as those that have no more than 100 employees. States have had the option of limiting pools to companies with 50 or fewer employees. Companies that are currently defined as modest businesses and grow beyond the size limit will be "grandfathered in" and treated similar those still within the 100 or 50 maximum.

Employer Revenue enhancement Exemption:The Hidden federal Subsidy That Helps Pay for Health Insurance. Read analysis by The New York Times, seven/7/2017.

POSTPONED: "Cadillac Tax" on High Cost Employer Plans.

On Dec. eighteen. 2015 an unusual bipartisan action past Congress and the President 2016 postponed the Affordable Intendance Act'southward (ACA) "Cadillac" taxation on high-cost health plans until 2020.  While the delay signals bipartisan support and momentum toward total repeal of the taxation, those discussions will continue through the transition to a new assistants in 2016. In the meantime, this two-year delay volition, at a minimum, provide employers additional time to consider appropriate measures to reduce excise taxation exposure.

The legislation as well addresses sure excise tax features as follows:

• The thresholds for triggering the tax will go along to exist indexed until the tax goes into effect in 2020 (the thresholds for 2018 were slated to exist $x,200 for self-only coverage and $27,500 for other than cocky-only coverage);
• Replacing a "not-deductible" definition, Employers will exist immune to deduct any "Cadillac" taxation payments; and
• The Comptroller General, in consultation with the National Association of Insurance Commissioners, will study suitable benchmarks to employ for age and gender adjustments to the thresholds triggering the tax.

Other ACA-related changes include a one-year moratorium on the ACA's annual fee on wellness insurers' cyberspace premiums (for U.s.a. risks) and a two-yr halt to the tax on sales of medical devices. These fees and taxes were probable to exist passed on to employers through increased insured plan premiums and provider costs, and thus will be welcome relief to employers.  [More than]

NCSL explains public employer coverage:
"ACA Requirements for Medium and Large Employers to Offer Wellness Coverage" - a 2016 updated report applicable to states, country legislatures and local governments every bit employers [download full report; vii pages, PDF]

Pocket-size Business organisation Health Care Tax Credit for Small Employers The SHOP law provisions assist minor businesses and small-scale tax-exempt organizations afford the price of covering their employees' wellness insurance. If a pocket-size business has fewer than 25 employees and provides health insurance it may qualify for a modest business taxation credit of up to 50 percent (up to 35 per centum for non-profits) to outset the cost of insurance, starting with the 2010 federal taxation twelvemonth. This can make the price of providing insurance significantly lower. Prior to 2014, the small business taxation credit was 35 pct (upwardly to 25 per centum for non-profits) for qualifying businesses.

• State-Run Small Business Wellness Options Programs: An Update Three Years Post ACA Implementation.
  Read the report on Shop insurer participation, enrollment, and use of the online portals. Today, 17 states and the Commune of Columbia operate a state-run Shop alongside an individual insurance marketplace, including Utah and Mississippi, which opted out of running an private market but built their own Store.  Many states continue to face challenges in convincing pocket-size employers and their brokers that the program offers value not bachelor elsewhere. More than data almost taxation credit uptake and enrollment through the federally run SHOPs would help policymakers and states brand a fair assessment of the benefits the SHOPs provide. Published past The Commonwealth Fund, July 29, 2016.

• Small Business Health Care Taxation Credit for Small Employers- IRS explanation of tax credit. Updated one/15/2015

Eligibility Rules

• Providing health care coverage . A qualifying employer must cover at least 50 per centum of the cost of health care coverage for some of its workers based on the single charge per unit.
• Business firm size. A qualifying employer must accept less than the equivalent of 25 full-time workers (for instance, an employer with fewer than fifty half-fourth dimension workers may be eligible).
• Average annual wage. A qualifying employer must pay average annual wages below $fifty,000.
• Both taxable (for profit) and tax-exempt firms authorize.
• Small Business concern Health Care Revenue enhancement Credit: Oftentimes Asked Questions - IRS guidance about Pocket-size Business organization Health Care Tax Credit.

Pocket-sized Business concern Redefined: On October vii, 2015, President Obama signed into law the Protecting Affordable Coverage for Employees (Pace) Act. The PACE Human action amends the definition of "pocket-size employer" in the Affordable Care Act (ACA) so that it would continue to use to employers with one to fifty employees, rather than changing to one to 100 employees as of 2016 every bit provided in the original ACA; however, the new legislation also allows states to opt for the ane-to-100 employee definition of small employer if they cull.

• The Centers for Medicare and Medicaid Services (CMS) released a series of ofttimes asked questions explaining how it volition implement the Step Human action (Dated Oct 19, 2015). States may elect to extend the definition of small-scale employer to comprehend employers with up to 100 employees by any ways that is legally binding nether state law, as long as the definition applies to all insurers, including those in the Small Business concern Health Options Plan (Shop) program. 46 states and D.C. have retained the 1-l definition; four states utilise the 1-100 option - (See MAP below)

Modest Concern Health Options Programme (Shop) Exchanges. ¹

Minor Business Exchanges take a framework fix past federal rules, including options for how employers can provide contributions toward employee coverage that meet standards for minor business tax credits. Store Exchanges are designed to serve equally a market for small employers' with one to 100 workers, or up to fifty workers if a state chooses that approach. Small employers with less than fifty full-time equivalent employees are not required to offer health coverage.

The ACA reformed small group marketplace underwriting and coverage, imposing the same guaranteed issue, modified community rating, and comprehensive coverage requirements on the small group market place that it imposed on the individual market. The ACA further created the Store exchanges to pool the enrollment of minor employers, potentially reducing administrative costs, and to offer individual employees a selection among health insurance plans. Finally, it created anew plan to make revenue enhancement credits available to small employers through the SHOP exchanges that would reimburse up to half of employer contributions towards premiums to pay for employee coverage.

Enrollment: July 2, 2015 update:  (adopted/excerpted from Tim Jost, Esq, Health Affairs Web log; alsoKevin Counihan, CEO of the Health Insurance Marketplaces, CMS Web log)

On July ii, 2015, CMS released for the start time numbers on effectuated enrollment in the SHOP exchange program.

With the troubled launch of the individual exchanges in the autumn of 2013, however, the SHOP substitution took a dorsum seat. The federally facilitated exchanges essentially delayed the launch of the Shop exchange for 2014 (although they did offering the tax credits) and delayed offering employee choice in many states for 2015. The federally facilitated exchanges fabricated online enrollment available to small employers in the 33 federally facilitated states starting time with the second open enrollment period in November of 2014. Many of the land exchanges offered SHOP exchanges from the time they opened enrollment in 2013.

As of May 2015, approximately 85,000 Americans had 2015 coverage through the Shop marketplaces through approximately x,700 small-scale employers. These totals do not include employers that enrolled their employees in 2014 simply had not renewed for 2015.Dissimilar the individual market, where open enrollment is only available in one case a twelvemonth, employers can enroll in the Store exchange at whatever time. Approximately 500 employers have been enrolling each month since Nov 2014.

These are small numbers compared to the millions of enrollees in the individual exchange. They may reverberate competition from private exchanges, which offer many of the aforementioned benefits of the SHOP exchange.Private exchanges cannot offering the tax credits, only the tight taxation credit eligibility requirements have limited their usefulness to small employers. In any event, the SHOP exchanges are launched and growing, and continue to have potential for making better coverage available to pocket-size employers and their employees.

Large Employers (100+)  mandated to offer health coverage

The Obama Assistants has modified the ACA statutory requirement that large employers (initially applied to those with 100 or more total-fourth dimension equivalent employees) have to offer health insurance or coverage, a 1 year date change from the original January. 1, 2014, now to Jan. ane, 2015.  This change was announced July 2, 2013, and modified in Feb 2014, described below.

Employers with 50-99 workers given until 2016 to offering coverage. On Feb. 10, 2014, the Treasury Department extended by one additional year the requirement that employers with between fifty-99 workers meet the mandate to offer health insurance, a category that includes about vii percentage of the private workforce. The new rules also volition require 70 percent of workers to exist covered in that showtime year. Read the Treasury fact canvas here [2 pp.] and concluding rule hither [227 pp.].

How the policy affects employers:

• These substantive policy changes have an impact on states and employers in every region. Small-scale Businesses with fewer than 50 employees: (about 96% of all employers): Nether the Affordable Intendance Human activity, companies that accept fewer than fifty employees arenot required to provide coverage or fill out whatsoever forms in 2015, or in whatsoever year, under the Affordable Care Act.

• Larger employers with 100 or more than employees (about 2% of employers): The overwhelming bulk of these companies with 100 or more employees already offer quality coverage.  Today'south rules phase in the percentage of total-time workers that employers demand to offer coverage to from 70 pct in 2015 to 95 per centum in 2016 and beyond. Employers in this category that do non encounter these standards volition make an employer responsibility payment for 2015.

• Employers with 50 to 99 employees (about ii% of employers): Companies with l-99 employees that practice non notwithstanding provide quality, affordable wellness insurance to their full-fourth dimension workers were to report on their workers and coverage in 2015, simply had until 2016 before any employer responsibility payments could apply.

POSTPONED Permanently?: "Cadillac Tax"

The So-Called "Cadillac Taxation" on Employers with High-Cost Plans (2020 and beyond)    Excerpt from Health Leaders mag, October 13, 2014
The tax on high-toll wellness plans, which are often referred to as Cadillac plans, is expected to affect a considerable share of the plans provided by healthcare organizations for their ain employees, equally much every bit 39% by 2020. The implications are significant because the excess-benefits tax requires the employer to pay 40% on the value of the portion of the plan that exceeds thresholds set past the Patient Protection and Affordable Care Act. Employers also need to consider that the tax is measured as a direct function of programme cost, and not actuarial programme value, and that a number of factors can drive excise-taxation exposure.

On Dec. eighteen. 2015 an unusual bipartisan action by Congress and the President 2016 postponed the Affordable Intendance Human activity'southward (ACA) "Cadillac" revenue enhancement on loftier-cost health plansuntil 2020.  While the filibuster signals bipartisan support and momentum toward full repeal of the tax, those discussions volition keep through the transition to a new assistants in 2016. In the meantime, this two-year delay volition, at a minimum, provide employers additional time to consider appropriate measures to reduce excise tax exposure.

The legislation as well addresses certain excise revenue enhancement features as follows:

• The thresholds for triggering the taxation will keep to be indexed until the taxation goes into effect in 2020 (the thresholds for 2018 were slated to be $10,200 for self-merely coverage and $27,500 for other than self-merely coverage);
• Replacing a "non-deductible" definition, Employers will be allowed to deduct any "Cadillac" tax payments; and
• The Comptroller Full general, in consultation with the National Clan of Insurance Commissioners, will study suitable benchmarks to use for age and gender adjustments to the thresholds triggering the tax.

Other ACA-related changes include a ane-twelvemonth moratorium on the ACA's annual fee on health insurers' internet premiums (for Us risks) and a 2-yr halt to the revenue enhancement on sales of medical devices. These fees and taxes were probable to exist passed on to employers through increased insured program premiums and provider costs, and thus volition be welcome relief to employers.

Read More:
"The Cadillac Tax: an Excise Tax on High Value Health Insurance Plans" - by Vermont Legislative Joint Financial Office. Online at: http://www.leg.state.vt.us/jfo/issue_briefs_and_memos/Cadillac%20tax%2025nov2014.pdf  - 11/25/2014

"The Cost of Spousal Health Coverage"

A 2014 report examines what tin can happen when companies looking to save health costs in 2014 require working spouses to get health insurance through their own employer.  Authors detect the motion has some unexpected consequences, according to a new written report by the nonpartisan Employee Do good Inquiry Institute (EBRI).

The federal Patient Protection and Affordable Care Act (PPACA) requires that employers with fifty or more workers provide health coverage to workers and dependent children until they reach historic period 26. It does non, all the same, require employers to provide health coverage to spouses, whether or non they are eligible for other health insurance. In 2011, primary wellness insurance policyholders spent an average of $5,430 on health care services, compared with $6,609 for spouses. This can brand them a target for employers looking to command their health benefit costs. [Total report online, seven pp., PDF]

• Description of ACA statutory requirements for employers, (detailed below) originally issued 2010.
• U.Due south. . Treasury Department Announcement: "Continuing to Implement the ACA in a Careful, Thoughtful Manner" - web log post by Mark J. Mazur, Assistant Secretary for Revenue enhancement Policy at the U.S.. Department of the Treasury. seven/2/2013.
• "Why liberals are abandoning the Obamacare employer mandate" - article by Politician Pro, 7/xv/2014
  More and more than liberal activists and policy experts who aid shape Democratic thinking on health care have ended that penalizing businesses if they don't offer wellness insurance is an unnecessary chemical element of the Affordable Care Human activity that may practice more than impairment than expert. Among them are experts at the Urban Institute and the Republic Fund and prominent academics like legal scholar Tim Jost.
• Implementing Health Reform: A One-Year Employer Mandate Delay - Wellness Affairs blog past Professor Tim Jost, 7/3/2013.>
• Exemptions from the Individual Mandate to have health insurance - Cited from U.S.. Treasury Department, updated 6/23/2013.

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Guidance on Store Exchanges - (Includes archive history 2013-fourteen)

The Centers for Medicare and Medicaid Services (CMS) issued guidance  in 2013 in the form of frequently-asked questions (FAQs) addressing Small-scale Concern Wellness Options Program SHOP)-Only Marketplaces. The first question asked addresses whether a state may operate a Shop while the individual market Market is operated every bit a Federally-facilitated Marketplace (FFM)? The guidance states that it is CMS' intention to propose through rule that, for 2014, a land that submitted a Design to operate a state-based marketplace and received conditional blessing may request to operate a country-based SHOP while the individual market Marketplace is operated as an FFM. All states had the same pick starting in 2015.

In  2013, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule outlining program integrity guidelines for the Health Insurance Marketplace (Marketplace) and premium stabilization programs.  The policies offer clarity on oversight of various premium stabilization and affordability programs, build on country options regarding the Small Business Health Options Plan, and provide technical clarifications.  The HHS fact sheet is online here.

Modest Business organization Health Options Plan (Store): Some Features Delayed.

States Implementing or Delaying Employee Choice in 2015

On May 27, 2014, a terminal rule "taking the next pace" in implementing "employee pick" in the Minor Concern Health Options Plan (Shop) was published by the Department of Health and Human being Services (HHS).  "Employee choice" provides employers the opportunity to allow employees to cull whatever health plan at the actuarial value, or "metal," level selected by the employer.  State Insurance Commissioners were given an opportunity to submit a written recommendation to the SHOP that employee option not be implemented in that state in 2015 if the Country Insurance Commissioner concluded that not implementing employee option would be in the all-time involvement of small group marketplace consumers in his or her land.

An HHS tabular array provides a tally: in total, 18 states with a Federally-facilitated Shop will allow for this transition relief in 2015. The remaining 14 states with a Federally-facilitated SHOP will bring together near State-based SHOPs and have employee selection bachelor to pocket-sized businesses in 2015. In 2015, about ii-thirds of Americans will live in states where small business workers tin cull a health plan rather than have their employer do it for them.

The following states with federally-facilitated exchanges (FFMs) implemented Employee Choice in 2015:Arkansas, Florida, Georgia, Indiana, Iowa, Missouri, Nebraska, North Dakota, Ohio, Tennessee, Texas, Virginia, Wisconsin and Wyoming. Small-Employer ("SHOP") Exchange Issues- Institute for Health Policy Solutions, 5/2011.  A report  "describes and assesses distinguishing dimensions important to the pattern of a successful Store Exchange program.
SHOPping Around- Setting up Land Health Care Exchanges for Small Businesses: A Roadmap- Center for American Progress, vii/2011.

1-  The CBO estimates that 24 million people volition purchase their ain coverage through the Exchanges in 2019. An additional 5 million people are expected to receive health insurance through the Exchanges because they work for an employer who allows all of their workers to choose among health insurance plans offered from the Exchange (though these individuals are not eligible for subsidies). While this puts the projected total number of individuals receiving coverage through the Exchanges in 2019 at 29 million, the CBO estimates consider these five million individuals covered by employment-based insurance.

Early Retirees and Employer Incentives   -- The ACA provides fiscal assistance to employers that continue coverage for early retirees, age 55-64 [HHS Fact Sheet]

State Decisions on Allowing Mid-Sized Employers (51-100) to Delay a Motion to the Small-Group Insurance Market (June 2015 update)

Beginning January ane, 2016, the ACA expands the definition of "pocket-sized employer" to mean a concern that employs between two and 100 employees. Experts fear this change could result in premium increases for some mid-sized employers with between 51 and 100 employees, which are currently included in the large-grouping marketplace, because they will become newly subject to several small-grouping market reforms.
A June 2015 analysis by The Republic Fund describes states' choices and deadlines.  Requirements include applying coverage rating rules such as not charging people more than for preexisting conditions and the requirement to cover a minimum set of essential health benefits. Equally a upshot, some policymakers and others take called for the delay or repeal of this provision.

State Options for Large Employers and Exchanges

States can choose to enact stronger consumer protections than these minimum standards for rating and selected other consumer protections.  Starting in 2017, states have the option of allowing health insurance issuers that offering coverage in the large group market to offering such coverage through the ACA Marketplace.  For states that choose this choice, these rating rules besides will apply to all large group health insurance coverage.  These rules standardize how health insurance issuers can price products, bringing a new level of transparency and fairness to premium pricing.  (Source: CCIIO/CMS Fact Sail, Feb 2013)

Employer Requirements to Offering Coverage (Includes Archive References)

Medium and Big Employers (with 50 or more full time employees [FTEs]) [Note delayed deadlines, announced July 2, 2013 and Feb ten, 2014 by the Treasury Department]	Employers with 50 or more employees, including for-profit, not-profit and government entity employers, generally are required to offer health insurance to each full-time employee.A For employers with fifty-99 FTEs, this requirement has been delayed for two years, to January 1, 2016, based on Treasury Department rules released February 10, 2014. [linked to a higher place] For employers with 100 or more than FTEs, this requirement has been delayed for one year, to January 1, 2015, according to Treasury Department announcements in July 2013. The offered insurance must meet the minimum essential coverage (MEC) requirement, defined as "Statuary level" where the health insurer plan will pay at to the lowest degree lx percentage of the cost of each wellness service or treatment; higher levels of coverage include "Silver" with 70% insurer payment, "Gold" at 80% insurer payment and "Platinum" at 90% are permitted. Such employers who do not offer coverage and practise take at least one total-time employee who receives a premium tax credit will be assessed a fee of $two,000 per total-time employee, but this excludes the get-go xxx employees from the assessment.  Such employers that offer coverage but that take at least 1 full-time employees receiving a premium revenue enhancement credit (bachelor upwards to 400% annual FPL) will exist required to pay the lesser of $3,000 for each employee receiving a premium credit or $2,000 for each full-fourth dimension employee, excluding the first 30 employees.  These provisions are effective Jan 1, 2014. IRS Regulations, Issued December 28, 2012; released December 31, 2012: [Includes excerpts] FAQs addressing Employer Health Care Arrangements , describing how marketplace reforms use to employer payment plans. The FAQs specifically address arrangements where an employer does not found a wellness insurance programme for their employees, merely reimburses them for premiums they pay for health insurance, and are considered to be a grouping health plan. Treasury updated April 2015. Treasury Department and the IRS proposed regulations (REG-138006-12) on the Employer Shared Responsibility provisions [full text = 144 pages] Starting in 2014 (but postponed until January. 1, 2015, or Jan 1. 2016), tax code Section 4980H, added by ACA, volition require employers with at to the lowest degree 50 full-time and/or total-time equivalent employees to offer affordable health care coverage that provides a minimum level of coverage, or pay a penalization. Co-ordinate to Section 4980H, an employee is considered to exist full time if he or she works at least xxx hours per week, and the proposed regulations "would care for 130 hours of service in a calendar month as the monthly equivalent of thirty hours of service per week." "Coverage for an employee under an employer-sponsored plan is affordable if the employee'south required contribution for self-only coverage does not exceed 9.5 percentage of the employee'south household income." Under the rules, employers must offer coverage to employees (postponed until January. i, 2015) and must offer coverage to dependents as well, starting in 2015.  The proposed regulations define an employee's dependents for purposes of section 4980H as an employee's child who is under 26 years of age. "Dependent does not include the spouse of an employee." [Source: Proposed Regs., p. 56] If an employer offers MEC nether an eligible employer-sponsored program to its full-time employees (and their dependents), information technology will not be subject to the penalty under department 4980H(a), regardless of whether the coverage it offers is affordable to the employees or provides minimum value. "A number of employers currently offering coverage only to their employees, and non to dependents. For these employers, expanding their health plans to add dependent coverage will require substantial revisions to their plans." The IRS planned to grant a one-yr reprieve to employers who fail to offer coverage to dependents of full-fourth dimension employees, provided they accept steps in 2014 to come up into compliance. Sources & Commentary: IRS web report: http://www.irs.gov/uac/Affordable-Care-Deed-Revenue enhancement-Provisions , 12/28/2012. The NY Times published this analysis: "The rules, though labeled a proposal, are more than significant than most proposed regulations. The Internal Revenue Service said employers could rely on them in making plans for 2014." 1/1/2013 " IRS Releases Proposed ACA Rules on Employer Shared Responsibility " BNA Revenue enhancement News, 12/31/2012.
Footnotes and explanations	A - To be subject to the Employer Shared Responsibility provisions, an employer must employ at to the lowest degree 50 full-fourth dimension employees or a combination of full-time and part-time employees that equals at least fifty (for example, forty full-time employees employed 30 or more hours per week on average plus 20 half-fourth dimension employees employed fifteen hours per week on average are equivalent to 50 full-time employees).  Employers will make up one's mind each year, based on their current number of employees, whether they will exist considered a large employer for the next year. For instance, if an employer has at to the lowest degree 50 full-time employees, (including full-time equivalents) for 2013, it will be considered a large employer for 2014.[Source: Q & A, Question #4,  by IRS, 12/28/2012]
Under l employees	PPACA exempts all employers with up to l full-time employees from any of the penalties or taxes applied in a higher place to 50+ employers.
Over 200 Employees	ACA Automatic ENROLLMENT REPEALED.  On Nov. ii, 2015 the President signed a congressional enacted provision to repeal section 1511 of the ACA. That provision required employers that utilize more than 200 employees and that offering health insurance to automatically enroll new employees in a health programme. Section 1511 farther requires employers to give employees notice that they tin can opt out of the plans in which they are automobile-enrolled in at whatsoever time. This was meant to encourage enrollment in coverage past employees who might otherwise non do and then if they had to initiate enrollment on their own.        Implementing the provision, which has been generally opposed by business interests, has been a very low priority for the assistants, and its repeal will not seriously touch on the general scheme of the ACA. The Department of Labor (DOL) guidance, issued in 2012, stated that it would not exist ready to implement the provision given the need to coordinate implementation of the provision with other more important provisions such every bit the employer mandate and the ban on waiting periods exceeding ninety days. It projected no deadline for implementing the provision. DOL reiterated that employers did non need to comply with the provision until information technology issued rules.        According to the Health Affairs Blog, the Congressional Budget Role (CBO) projects that repeal of this provision would reduce the number of people covered by employer-sponsored insurance by 750,000 start in 2017 when the provision might first exist enforced.# #  CBO estimated that ninety percentage of these people would remain uninsured. Repeal would reduce the budget arrears by $7.9 billion over the 2016-2025 period because employees would receive more taxable income rather than wellness benefits, which are not taxable, and considering of increased private responsibleness penalisation payments.

Sources : CMS/CCIIO notices and guidance, vii/two/2012, 2/x/2014; 6/two/2014; Summary of Health Reform Constabulary, Kaiser Family Foundation 4/23/2013

ACA statutory exemptions from the requirement to obtain minimum essential coverage

There are statutory exemptions for ix categories of individuals, based on the definitions beneath.  Additional exemptions have been added by regulations, issued 2012-2018. (#10 and in a higher place)

Sources: Treasury Department - Questions and Answers on the Individual Shared Responsibility Provision - Updated 2015
Individual Shared Responsibility Provision – Exemptions: Claiming or Reporting - IRS - Updated 2015
The Private Shared Responsibleness Provision- A consumer and taxpayer caption - IRS - Updated  2015

1. Religious conscience: Persons who are a member of a religious sect that is recognized as conscientiously opposed to accepting whatsoever insurance benefits. The Social Security Administration administers the process for recognizing these sects according to the criteria in the law.
2. Unaffordable coverage options:  Persons who can't afford coverage because the minimum amount that must be paid for the premiums is more than than eight percent of their household incomes.
3. Hardship: A Health Insurance Market, also known as an Affordable Insurance Exchange, has certified that a person has suffered a hardship that makes him/her unable to obtain coverage. This category has recently been expanded to include those who are homeless, facing eviction or foreclosure, victims of domestic violence, and victims of floods, fires and other disasters.
4. Health intendance sharing ministry building: Persons who are a fellow member of a recognized health care sharing ministry.
5. Indian tribes: Persons who are a fellow member of a federally recognized Indian tribe.
6. No filing requirement: Persons whose household income is below the minimum threshold for filing a taxation return. The requirement to file a federal tax return depends on a person'due south filing status, age, and types and amounts of income. Requirements are detailed in the IRS Interactive Taxation Assistant (ITA).
7. Curt coverage gap:  Persons who went without coverage for less than 3 consecutive months during the year. In general, a gap in coverage that lasts less than three months qualifies every bit a short coverage gap. If an individual has 2 brusque coverage gaps during a year, the brusque coverage gap exemption only applies to the kickoff or earlier gap.
8. Incarceration: Persons who are in a jail, prison, or similar penal institution or correctional facility subsequently the disposition of charges against them.
9. Non lawfully present:  Persons who are neither a U.Due south. citizen, a U.South. national, nor an alien lawfully present in the U.S.
   OTHER REGULATORY EXEMPTIONS
10. Coverage gap due to Medicaid not expanded:  Whatsoever person or family residing in a state that has declared it has non expanded the country Medicaid program to 138 percent of federal poverty (FPL), and having an annual income below 100 percentage of that FPL.
11. Canceled policies: People whose 2013-14 policies were canceled and consider the available culling policies "unaffordable."
12. Other hardships: a more open-concluded exemption for persons who have other, unspecified hardships in obtaining insurance.  This requires a written appeal to HHS or an HHS-authorized state dominance.

2017: Trump HHS List of Hardship Exemptions, with links to details, forms, and instructions. [Updated seven/22/2017]

1. You were homeless

2.     You were evicted or were facing eviction or foreclosure

3.     You lot received a shut-off discover from a utility company

4.     You experienced domestic violence

5.     Yous experienced the death of a family unit member

6.     Y'all experienced a fire, flood, or other natural or human-acquired disaster that caused substantial damage to your property

7.     Y'all filed for bankruptcy

8.     You had medical expenses you couldn't pay that resulted in substantial debt ^//

9.     You experienced unexpected increases in necessary expenses due to caring for an ill, disabled, or aging family member

10. Yous claim a child as a tax dependent who's been denied coverage for Medicaid and Fleck for 2017, and another person is required past court club to give medical support to the child. In this case you don't have to pay the penalty for the child.

11. Equally a result of an eligibility appeals decision, yous're eligible for enrollment in a qualified wellness program (QHP) through the Marketplace, lower costs on your monthly premiums, or cost-sharing reductions for a time catamenia when yous weren't enrolled in a QHP through the Marketplace in 2016

12. You were determined ineligible for Medicaid because your state didn't aggrandize eligibility for Medicaid in 2017 under the Affordable Intendance Act

13. Your "grandfathered" individual insurance plan (a plan you've had since March 23, 2010 or earlier) was canceled considering it doesn't meet the requirements of the Affordable Care Act and you believe other Marketplace plans are unaffordable

14. You had another hardship. If you experienced some other hardship obtaining health insurance, use this form to describe your hardship and apply for an exemption.

2018-2019 Expedited Mandate Exemption Procedure past HHS/CMS
On Sep. 12, 2018"CMS/CCIIO  announced a new way for consumers to claim a hardship exemption from the shared responsibleness payment for 2018 on a federal income tax return without obtaining an exemption certificate number from the Substitution. Consumers can claim hardship exemptions either through the FFE (federal exchange) using the existing application processes or on a federal income revenue enhancement return for circumstances like a natural disaster, deprivation of food, shelter, clothing, or other necessities, and/or other events the Secretary has determined plant a hardship with regard to the capability to obtain health coverage. HHS will proceed to procedure these exemptions under the current regulations for exemptions practical for through the FFE and for all State-based Exchanges (SBEs) that choose to have exemptions candy by HHS."
♦ Press Release is live online    ♦ Hardship Exemption Guidance:

Financial impact of the individual mandate (2017 data)(compiled 2017 by the Washington Mail):

• The current penalty for not having coverage is $695 per developed and $347.l per child — up to $2,085 per family — or 2.5 percentage of family income, whichever is greater. Roughly half dozen.5 million taxpayers paid a fine for being uninsured in 2015, according to the Internal Acquirement Service, though the fine that year was $470 per adult.
• The Congressional Budget Function projected in a December 2016 report that abolishing the individual mandate could leave an additional fifteen 1000000 Americans uninsured by 2026, while saving the federal regime $416 billion in subsidies to ACA consumers and Medicaid payments.

Rate Review Provides Savings for Small Business concern Health Policies

Minor Group Market:  In the small group market, assay of the data from 35 states indicates that the implemented rate increases are approximately 19 percent lower than the rates originally requested past insurance companies.[half-dozen]  This deviation equates to approximately $866 million in savings to consumers based on 2012 small grouping market premium data.  For the 35 states, 18.7 per centum of full covered lives had charge per unit requests reduced or denied.  Extrapolating to the total number of xviii.1 million covered lives in the small group market, an estimated 3.4 one thousand thousand individuals had rate requests reduced or denied.
Equally with the private market data, the small-scale grouping premium data are based on MLR information from 50 states and the Commune of Columbia,[seven] whereas the boilerplate difference between rate changes requested and rate changes implemented is taken from ASPE's analysis of 35 states in the pocket-size group market using RRG data and information from Florida, a non-grant land.  Again, the results were extrapolated to gauge a national savings total for the small group market as a effect of rate review.

Rate Change Requested Versus Charge per unit Change Implemented in the Pocket-sized Group Marketplace

Archive Instance: Modest Group Market Charge per unit Modify, 2012	Requested	Implemented
Number of rate filings in 35 states	772	772
Number of covered lives affected by these charge per unit filings	10,938,053	10,938,053
Average rate alter for 35 states	5.8%	4.seven%
Average charge per unit change when request >=x% for 35 states	xvi.3%	nine.7%
% filings with rate alter requested >=10% for 35 states	14.0%	11.vii%
% covered lives with charge per unit change requested >=10% for 35 states	14.7%	9.3%
% covered lives with rate change request reduced or denied		18.7%
Total covered lives with charge per unit change request reduced or denied based on 18.one million total covered lives for all states		three.iv million
Total U.S. savings based on $78.7 billion total premiums for all states		$866 million
Sources:  Revised State Rate Review Grant (RRG) data and data from state websites plus data from Florida (non-grant state)

Total premiums in the individual and small group markets were lower by an estimated $1.ii billion compared to the total premiums initially requested.

ARCHIVE: State Consumer Protection Examples and Initiatives from the Decade earlier the ACA

For more than contempo state examples, please visit NCSL'south Health Insurance Reform Enacted Laws Related to the ACA, 2011-2014.

• Small-scale Group Guaranteed Consequence - 2013 [links verified 6/29/2017]
• Small Group Rate Restrictions -2013
• Small Group Pre-Ex Condition Exclusion - 2013
• Individual Market Portability Rules.- includes pre-exising conditions-2013
• Rate Review, Private and Minor Group  -2012

Source for Small Group Tables: Land Health Facts, Kaiser Family Foundation online.

Land	Description/ Additional Data
Colorado	Colorado enacted the Fair Accountable Insurance Rates Act, H 1389; information technology requires individual and modest group health insurance carriers to file with the Commissioner of Insurance a detailed clarification of their rating, underwriting and renewal practices; requires approval past the commissioner for sure rate increases.  It was signed June five, 2008.
Florida	Florida Rolls Out Health Plan Comparison Web Site- Florida launched an insurance comparison Spider web site that allows residents to check the benefits and premiums for small-scale employer health plans offered in the state, the South Florida Business Journal reported on June 26, 2006.
Kansas	Existing Kansas Tax Credit Complements New Federal Credit.  Businesses may authorize for the country credit if they employ between two and 50 people and have non contributed to health insurance premiums or health savings accounts for their employees in the preceding two years. The credit can be worth $70 per month per employee for the start yr, $50 for the 2nd year and $35 for the third and final year of eligibility.  This benefit tin exist added to the federal tax credit that eligible modest businesses tin can claim starting this twelvemonth. (Report by Kansas Wellness Establish News, ane/10/2011)
Kentucky	Kentucky'southward House passed HB 445 & HB 380 in 2006, as the Insurance Coverage, Affordability and Relief to Small Employers (ICARE) Program to make wellness insurance more than affordable for small employer groups; including land subsidies, aimed as a 4-year pilot project for employer groups with ii to 25 employees.
Maryland	On November xix, 2007, the Working Families and Small Business concern Health Coverage Act (Senate Bill 6) was signed into law, offer subsidies to small businesses to offset the toll of providing coverage to employers and expanding Medicaid eligibility to sure adult populations. Provisions included in the new constabulary include: The provision of subsidies to minor employers and employees of small employers if the employer:  a) has not offered a wellness benefit plan within the prior 12 months; b) has two to nine eligible employees; c) meets sure low-wage requirements to exist established through regulation; d) establishes a Section 125 payroll deduction program to allow for pre-tax premium contributions; and e) agrees to offer a health benefit that is designed to prevent illness, reduce poor clinical outcomes, and promote health behaviors and lifestyle choices. The expansion of Medicaid eligibility up to 116 percentage of the Federal Poverty Level (FPL) for parents and flagman relatives with a dependent child living at home. The stage-in over 4 years of Medicaid eligibility up to 116 percent FPL for childless adults—enrollment may be capped and benefits may be express based on available funding; and The legislation is financed through a combination of general funds, hospital uncompensated intendance savings, a 1-time surplus from the state'southward high hazard pool, and federal funds. The availability of general funds for the childless adult expansion depends on the adoption, through public plebiscite, to add a new article to the Maryland Constitution to authorize video lottery terminal gaming (slot machines) in the land. The state wanted to focus on its smallest businesses because that is where the lack of wellness insurance is well-nigh acute, says John Colmers, secretarial assistant of the Maryland Section of Health and Mental Hygiene. Reimbursement goes direct to the health insurer, so agents nonetheless become total commission on their auction, but the employer gets a nib that's half the size it would otherwise exist. As of January 2009, virtually 550 individuals are enrolled; the department is hoping to enroll 1,500 businesses during the year. In addition, the Governor, through an October 2007 executive gild, created the Maryland Health Quality and Cost Council. Health care aid: New for 2009- CNN Money, ane/09.
Montana	Insure Montana is the programme launched in Jan 2006 to begin addressing the trouble of uninsured Montanans.  This is a two part program that is designed to assist minor businesses with the cost of health insurance, whether they have provided wellness insurance previously or not. Small businesses with two-9 employees that are currently providing health insurance to their employees are eligible for refundable tax credits.  For businesses that were previously unable to afford health insurance for their employees, Insure Montana provides wellness insurance coverage through a small business purchasing pool. Over 1550 pocket-size businesses were enrolled and 10,000 lives were covered as of August 2007 and a new applicants waiting list was started due to funding constraints. As of January 2009, both the taxation credit and purchasing pool programs were at full capacity considering of limited funding. Small businesses applying for either are being put on a waiting list. The program is entirely funded through increases in Montana'due south tobacco tax, but that's non enough. The country accountant'south office has requested boosted funding - nearly $12.5 1000000 for the next two years to comprehend those waiting and new applicants. Wellness intendance help: New for 2009- CNN Coin, 1/09.
New Hampshire	New Hampshire governor signs HealthFirst insurance program. The HealthFirst initiative will require major insurance carriers to offer a standard wellness plan for businesses with upwards to 50 employees. Premium costs will be controlled by focusing on prevention, managing chronic conditions and promoting best practices.   A commission whose members include small business organisation owners will design the wellness programme with a target premium of ten per centum of the prior year's median wage, currently about $262 a month. An actuary will assess whether the programme tin can be offered for the target price earlier insurers are asked to provide information technology, starting October 2009, v/08. The New Hampshire Small Employer Health Reinsurance Pool selected Pool Administrators Inc. as the administrator for the New Hampshire Small Employer Health Reinsurance Pool.  Small-scale Employer Health Carriers are able to reinsure with the puddle constructive January ane, 2006.
New United mexican states	New Mexico Land Coverage Insurance- A 2005 law for uninsured employed adults. A unique public–private partnership that provides affordable wellness insurance products for modest employers (with fifty or fewer employees) who have previously been unable to afford coverage for their employees. Employers are expected to contribute $75 per employee per month, and employees pay premiums upward to $35 per month and copayments.  37,000 individuals were enrolled equally of June 2009. "Minor Concern Participation in the New Mexico State Coverage Insurance Program: Evaluation Results." - The Hilltop Institute (University of Maryland) Analysis Brief, 2/9/10.
New York	New York's HealthPass offers pocket-size businesses and sole proprietors a wide range of attractive health insurance options that enable eligible employees to choose a program that best fits their medical needs and budgets. HealthPass serves minor businesses and non-profit organizations in New York City, Long Island, Westchester, Rockland, Orange, Dutchess, and Putnam counties. More than ii,500 employers currently offering HealthPass plans to their employees and families. Information technology operates as a partnership among the New York Business Group on Health, the Metropolis of New York, and the health insurance industry; enrollment surpassed 20,000 members equally of vii/9/2008. Healthy New York: a plan to provide publicly-funded or other type of financed reinsurance for private coverage to assume a portion of insurer's loftier-cost claims. The state subsidizes cost for high-cost people using more the $5,000 per twelvemonth, with the goal of lowering premiums for all, based on the knowledge that twenty percent of people account for 80 pct of health care spending. The state requires all HMOs to offer the Healthy NY product. Applicants may now cull a benefit package with a limited prescription drug do good or i without prescription drugs. Small firms with low-wage workers, low income self-employed and uninsured workers without access to employer sponsored insurance may enroll.
Ohio	Rep. Jim Raussen reported that SB five initially would have allowed small-scale employers to offering health care plans that didn't include all of the state's coverage requirements, in hopes of creating a more than affordable health insurance production for small businesses.   Those and then-called "mandate-lite" provisions have been removed from the nib because other states' experience showed few businesses bought the product, and the savings were only about 3 to 5 percent, Raussen said.  Senate Nib 5 now mostly includes provisions to allow pocket-sized businesses to create alliances to buy health insurance.  This bill became law in March 2007.
Oklahoma	Governor Henry signed a police force on June 4, 2007, targeting working Oklahomans by expanding "Insure Oklahoma," a program that helps pocket-size businesses provide wellness insurance for their employees.  Under House bill 1225, the constabulary expands eligibility in the program from businesses with 50 employees to those with 250 or fewer workers. Under the program, the state pays 60 per centum of the insurance costs, the employer pays 25 percent and the employee pays the remaining 15 percent. The bill also would expand eligibility in the program to workers who earn 185 percent of the federal poverty level to a 250-percent threshold.  Every bit of September 2008, the program has about 10,000 employees enrolled — almost of whom were uninsured before — that is far below expectations for a program that could adjust 4 times that corporeality. The Oklahoma Employer/Employee Partnership for Insurance Coverage (O-EPIC) programme was created to assist small businesses in offering their employees health insurance. Participating employers with 250 or fewer employees must contribute 25 pct of the employee's premium and must offer a qualified O-EPIC plan. The state funds sixty percent of the insurance costs, and the employee pays the remaining 15 per centum. Participating employees have incomes below 250 pct of poverty. Qualifying O-Ballsy plans are required to cover land-divers basic benefits and take maximum out-of-pocket spending limits.
Rhode Island	On July 3, 2007 Senate Bill 448 was signed into police force, establishing a state-wide requirement that employers offer employees the opportunity to buy health insurance with pre-tax income.  The land Insurance Commissioner notes that 39 percent of Rhode Island workers do not take admission to employer-sponsored insurance.  Neither the country nor employers are required to contribute to the purchase price, only the state estimates a savings of "up to 40 per centum" of the premium toll, depending on revenue enhancement bracket.
South Carolina	Governor Marking Sanford on February nineteen, 2008 signed a bill, S.588 (Human action No. 180), that gives small businesses more than flexibility to provide health insurance for their employees.  The neb allows a group of at least ten small businesses to bring together together and negotiate cheaper insurance rates than an individual business.  Current state law allowed businesses to join together for health insurance simply sets a minimum of i,000 employees. The new police defines minor business equally two-50 employees, and permits an employer of 1 to qualify subject to dissever pricing terms. Gov. Sanford Praises Passage of Minor Business Healthcare Nib, News Release, 2/19/08.
Tennessee	In Tennessee, SB 4014 of 2008 allows small businesses of 2 to l employees to puddle together for the purpose of negotiating better insurance rates, creating a pocket-sized concern cooperative. The bill is designed to encourage more than small employers to buy health insurance and to requite them predictability and stability in health-insurance rates.  It was signed May 28, 2008. CoverTennessee -  A market based public/private partnership program for small employers and uninsured workers with incomes beneath 250 percent of FPL. ($25.5k /yr for one; $51.6k for family of 4).  Comprehend Tennessee is guaranteed access to basic, major medical coverage for $150 a month with the price shared as by the individual, employer, and land regime.  Tennessee tripled its taxation on cigarettes to produce $239 million in new revenue for FY 2008.  The premium for coverage is shared among the employer, employee, and state, with each party contributing 1/3 of the costs of the premium.   CoverTN plan benefits are "very limited in nature compared to traditional insurance. For instance, these plans do not have an out-of-pocket maximum, and therefore do not protect against the potential of catastrophic medical costs. In other words, there is no limit to the amount of medical bills a fellow member might take to pay for a major illness or injury, such equally affliction handling, or injuries sustained in an automobile accident for case. Therefore, CoverTN is not a low-toll alternative to traditional insurance coverage." 2008 Expansion:  Beginning Jan. ane, 2008, more Tennesseans will be eligible for CoverTN, the premium subsidy program for the working uninsured. When CoverTN was launched nearly six months ago, it covered workers who earned up to $41,000 in pocket-size businesses with 25 employees or less. The country pays one-third of the premiums, the employer may choose to pay one-third and the employee one-third. If the employer chooses not to participate, the employee may pay two-thirds. Premiums for the bones benefit plan are about $150 a month and coverage is portable. The state plans to expand the program by opening it to individuals with annual incomes of up to $43,000, and in companies with up to 50 employees. Well-nigh 13,000 Tennesseans are currently enrolled, and administrators hope to increase enrollment to 100,000 by 2010.
Texas	In 2007, the Senate passed and a House committee gave favorable recommendation to SB 922, which would encourage counties to test models for small business organization coverage. Intended to maximize flexibility and local command, the legislation would enable county commissions to institute local or regional health-care programs, which could offer insurance or health services.  The state Health and Human being Services Commission would use general revenues to provide start-up grants to seven of these programs, which could include health savings accounts and loftier-deductible plans. The grants would boilerplate $150,000 each, for a total cost of $one.05 million in FY 2008. In addition, the local/regional programs could apply for additional funds from a "wellness opportunity pool," created nether an 1115 waiver from Medicaid.  It is expected that employers, employees and the state would jointly share the cost of premiums or health-care services. The programs would be required to allow any private who receives land premium assistance to enroll.   The bill did not laissez passer the Business firm. Incentives could boost employee health care- Senate studies tax breaks to assist small firms provide insurance. The incentive under consideration will probably exist in the form of larger tax deductions for companies that offer wellness care plans to their employees. Dallas Morning News, 2/ane/07.
Utah	Program Assists Uninsured to Get Health Coverage.  Because of passage of HB276 in 2006, the Utah Department of Health launched a new rebate program for health insurance premiums that would reduce the number of uninsured citizens in Utah by helping workers pay for their employer- sponsored health insurance. Qualified workers can receive rebates up to $150 per developed and $100 per child to help pay the monthly premium of an employer-sponsored health care plan. HB276 provided $267,000 in state funding for the program and allows matching federal Medicaid money. Utah besides created the Utah Health Exchange, an internet-based country programme, comparing insurance options and providing greater transparency of insurance plan benefits, serving the individual and small group markets. The exchange allows employees to combine defined contributions from one or more than employers along with pre-taxation personal contributions to purchase insurance that as well is portable. All small employers with ii to 50 people will have access to the commutation Jan 1, while large employer groups volition take to wait until 2012. Utah's exchange differs from so-called health insurance purchasing cooperatives ready past groups of modest employers in some states to use their commonage purchasing power to reduce premiums.  Many of those cooperatives remained modest and did not concluding long.  As report by Workforce Direction, "Equally the premium went upwardly and the good risk left the group, you'd end up in this death spiral and the grouping died," says Larry Boress, president of the Midwest Business Group on Health.  The Utah exchange is intended to do what the purchasing cooperatives could not—simplify health plan administration, offering employees more choice and keep health care costs fixed.  "What'due south revolutionary about the Utah exchange is the divers-contribution piece for concern," says Samuel C. Gibbs, a senior vice president with Mountain View, California-based eHealth, an online health insurance portal. Utah is using eHealth'south Net platform for a similar insurance commutation for individuals.  Utah'southward  law now allows employers to contribute a fixed-dollar amount to a person's health insurance, enabling them to customize their contribution for each individual, and send one bank check one time a calendar month to the commutation ambassador. A split up part of this reform creates NetCare, a low-toll mandate-free insurance choice for insurers to offer to the individual and small-business markets and for those eligible for COBRA, mini-COBRA or conversion coverage."  Enrollment launched Baronial 19, 2009, based on HB 188, enacted into law in March 2009.  In the two-calendar week enrollment flow that closed at the terminate of August, 136 businesses employing a combined 2,333 workers signed upward. The average size of companies enrolled is 17 employees. What Utah's Wellness Reform Means to Small Concern - BusinessWeek, ix/04/09. Utah Substitution May Offer New U.S. Health Care Insurance Model- Workforce Management, 9/17/09.
Washington	A 2007 law, HB 1569 established the Washington Wellness Insurance Partnership. Similar to the "Connector" mechanism created in Massachusetts, the Partnership will offer benefits administration to small employers that take at least ane employee who earns less than 200 pct of the federal poverty level (FPL). The Partnership besides will provide sliding-calibration premium subsidies to individuals who earn less than 200 percent of the FPL. It also authorizes evaluating the inclusion of additional health insurance markets in the health insurance partnership and studying the impact of health insurance mandates.  Information technology became law 5/ii/07 every bit Affiliate No. 2007-260. Plan implementation has been halted due to a budget arrears. (as of August 2009)
Due west Virginia	West Virginia Small Business organisation Programme - A 2004 police force (S.B. 143) intended to help uninsured small businesses provide coverage for their employees. This is a public-private partnership between the West Virginia Public Employees Insurance Bureau (PEIA) and participating insurance carriers by allowing carriers access to PEIA's provider reimbursement rates. The pattern of this programme included coverage in both primary care and major medical at a cost that is twenty-25 per centum lower than the retail rates.

State Subsidized Enrollment: Results Are Mixed
In the summertime of 2007, NCSL compiled an breezy survey summary of actual numbers of residents who enrolled in state initiated small-business concern programs.  Enrollment feel is different state-to-state.  Historically, employer participation in government created subsidized programs has not been extensive.  States take had more than success with enrolling individuals at the employee level and non going through the employer. Participation is also very much related to outreach and marketing.  For more data nerveless past NCSL'due south Primary Care Project, please visit State Programs to Subsidize or Reduce the Cost of Health Insurance for Modest Businesses.

NCSL Online Resources

• State Legislation on Health Savings Accounts- NCSL written report, updated 2014
• State Legislation Relating to Disclosure of Hospital and Wellness Charges- NCSL Written report, updated 2014

Athenaeum:

• Country Programs to Subsidize or Reduce the Cost of Wellness Insurance for Minor Businesses and Individuals- NCSL's Main Intendance Project, 2009.
• State COBRA Expansions for Small Businesses- 39 states and DC aggrandize COBRA regulations to small businesses (ii-xix employees). The 2009 federal stimulus law expanded benefits and offered new opportunities for country coordination, 12/2009.

Note: NCSL provides links to other Spider web sites from time to time for information purposes but. Providing these links does not necessarily indicate NCSL's support or endorsement of the site.

Compiled past Richard Cauchi, NCSL Wellness Program-Denver.  Earlier research conducted by Steve Landess (2012-xiii)

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Source: https://www.ncsl.org/research/health/small-business-health-insurance.aspx

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