Monday, May 20, 2013

Affordable Care Act

On October 1 2013 all employers will be required to give employees model notices about Exchanges. In California the Exchange is called Covered California.. There are two separate forms. One is for employers who provide health insurance and another for employers who don’t. The forms are currently available from the Department of Labor. It is not clear whether California will come up with its own form.

The notices will

Inform employees of the existence of state health care Exchanges

Explain what services will be provided

Explain how the employee may contact the Exchanges to request assistance

Detail how employees may be eligible for a premium tax credit or cost sharing sharing reduction if the employers plan does not meet certain requirements.

You have all heard that employers with 50 full time employees or full time equivalents will be required to provide a qualified health plan or pay a penalty. The penalty is $2000 if the employer does not provide insurance or $3000 if they do provide insurance and the cost is 9.5% or more to the employee. Full time employees are defined as 30 hours a week. The fine will only be applied if the employee purchases insurance through the Exchange with a subsidy.

For people interested in getting an estimate on the cost of individual coverage in Covered California go to

For those of you in San Francisco and subject the Health Care Security Ordinance it is not clear how this will reconcile with the ACA. We know that the coverage provided by SF is not insurance. We also believe that money an employer puts into the medical reimbursement account cannot be used as pretax dollars for an employee to purchase insurance. The City attorney is looking into this.

The City Attorney is also looking into how employer payments can be provided to employees for medical and dental cost by employers.

Time is running short for the answers to these questions.

Scott Hauge


Small Business California

2311 Taraval Street

San Francisco, CA 94116


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