Many small employers have a tough time getting a good deal on health coverage under the current system, especially if they have employees who are older or in less- than-perfect health. They tend to pay more for worse coverage than large employers.
All that would change under health reform, thanks to three key features:
- New tax credits to help make coverage cheaper
- Exchanges to make it easier to offer coverage and provide a richer array of choices for employees
- Exemption from the employer penalties that larger firms face if they don’t offer health coverage to their workers.
If you have a small business, the effects of health reform depend on how exactly how small you are. Here’s the scoop:
If you’re self-employed, with no employees…
- In almost all states, you would shop in the exchange as an individual and, depending on your income, you might be able to qualify for the tax credits being established for individuals and families. But you wouldn’t actually be treated as a small business as described below.
If you’re a small business with 1-24 employees…
- Your business would be eligible for the new health coverage tax credits if the average wage of your employees is less than $50,000 a year and you contribute at least 50 percent to the premium. These tax credits—worth up to 35% of the employer’s premium contribution—begin in 2010. In 2014, the credits become a little larger (up to 50%) but they can only be used for coverage offered through the new exchanges. This second, larger tax credit can only be claimed by a given business for two consecutive years.
- You can offer coverage through the new exchanges when they open in 2014 (and possibly earlier if your state chooses to enact this reform sooner). The exchanges will have many insurance coverage choices. If you like, you can just make a fixed contribution to your employees’ coverage, and let them pick from among the available options. So employees with different needs can make different selections—a great benefit that doesn’t raise your costs. If exchange coverage doesn’t suit you, you’ll have other options. The coverage you have today will be “grandfathered” in, so you can keep it if you want to. Or, you can choose from among plans sold outside the exchange.
- You are exempt from the employer penalties that larger firms face.
If you’re a small business with 25-49 employees…
- If your FTE employees exceed 24, you are not eligible for the new tax credits.
- You can offer coverage through the new exchanges when they open in 2014 (or earlier, depending on how quickly your state enacts these reforms), thereby providing an array of choices to your employees. As is the case with smaller businesses, the coverage you have today will be "grandfathered" in, so you can keep it if you want to. Or, you can choose from among plans sold outside the exchange.
- You are exempt from the employer penalties that larger firms face.
If you’re a small business with 50-100 employees…
- You are not eligible for the new small business tax credits.
- You can offer coverage through the new exchanges in 2016, and possibly earlier, depending on how your state chooses to enact reform. You’ll have the same options as smaller employers.
- You are subject to the employer penalties that larger firms face. This means that if you don’t offer coverage to your full-time employees, you have to pay a penalty. It would be $750 per employee under the Senate bill, and $2,000 per employee under Obama’s proposal, but with an exemption for the first 30 workers.
—Lynn Quincy, Senior Policy Analyst












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