I own a 75 employee company. Am I forced to buy health insurance for all under Obamacare?

Or am I merely only required to offer a group plan for them to purchase?

(the scenario is fiction but the question is not)

I’m sure others will chime in with opinions but why not start with the facts:



Off the top of my head, I believe that you must provide access to a group plan with a certain minimum benefits (e.g. You can’t call it Health Insurance if it has a $1M deductible and nothing is covered) and an employee’s contribution can’t exceed 10% of his income (for the employee alone; for a family plan you can ask for the moon).

I’m sure there is more, but that’s the crux of it.

You aren’t even required to offer a plan. If you choose not to offer any healthcare coverage there is an assessment fee.

Essentially that fee goes into the governments coffers to subsidies plans for people such as your employees that aren’t offered insurance through their jobs. I’m not sure where the numbers are at now, it was cheaper to pay the fee rather than offer insurance but not by a lot.

No, you need to hire an additional 25 people and work everybody at 30 hrs a week.

What makes you think the top performers won’t just quit and find a job elsewhere if this occurred?

Doing this works for low-skill businesses, but valuable people will just balk.

high skilled jobs usually come with insurance.

The quick answer is no, with the caveat that a penalty may be assessed. If you employee 50+ FT employees (which can include PT employees based on a calculation) you must offer a plan which covers the essential health benefits, has an actuarial value of 60% or higher and is affordable. Affordable is defined as costing the employee no more than 9.5% of their salary. If you do not offer coverage that meets the above guidelines and even 1 employee gets coverage the the individual exchange and receives a premium subsidy, then you will be subject to a penalty.

“10% of his income” … I assume this means 10% of the gross wages that you are paying that employee. Is that correct?

Is the fee that you have to pay if you don’t offer insurance spelled out clearly?

How many of your employees are full time workers? If you have less than 50, and the full-time equivalency of the remaining employees wouldn’t bring you over that number (unlikely, but possible) you are not covered by the mandate.

What the…, the penalty is equal to $2,000 for each of the total number of employees in the firm minus 30. Assuming the OP’s workers are all full time, and he offered no plan at all, he’d be subject to a $90k penalty [(75-30)(2,000)].

This thread isn’t getting much action… are there others dealing with some of the basics?

Back to the details … $2,000 sounds like alot but would be less than offering insurance unless you can get the employees to pay most of the cost.

What options would an employee have and at what cost?

Can he decide he doesn’t want to pay, say, $10,000 a year and opt out of that coverage and get it cheaper from an exchange?

… or are the exchanges only available if you aren’t offered coverage by your employer.

Do we even know what the exchanges will cost? My understanding is that the info on this year’s income tax return will be used in some manner to determine what you can afford and, therefor, how much you have to pay. I could be all wet though.

It’s not really helpful to spend much time pondering hypotheticals that aren’t likely to match very many companies in real life. We have 75 employees and not even the owners and managers have health insurance? While comparing costs of insurance and penalties, we should also look at reducing FTE count via independent contractors, outsourcing labor (such as through a PEO) and splitting one company into multiple independent companies, but we can’t address those options without knowing job duties, employee locations and industries involved.

And the exchanges are not set up yet, so no one can answer about them.

In the end, the OP is a question along the same lines as “Let’s imagine I have advanced stage cancer. What’s the best treatment?” There’s no answer that any professional can really give other than “Go find professional advice.”


I have found this site - Kaiser Family Foundation to have easy to understand information about the ACA.

Are you sure you didn’t confuse prices with subsidies? I can see how last year’s income will be used to determine if you qualify for a low income subsidy when buying your own health insurance.

If are buying your own coverage in an exchange and you don’t qualify for a subsidy, then you have to choose a plan - which vary in price according to whether you choose a Bronze, Silver, Gold or Platinum plan - not with your income. Those designations are standardized and will mean the same in each state and from each provider.

The one thing I am sure about is being confused :smiley:

WRT to the % of income question here is something I found on another message board. It looks like the test is based on info other than the employee’s gross wages from that employer.

Robert Pear reported in The Times recently, the law considers a worker’s share of the insurance premium unaffordable when it exceeds 9.5 percent of the worker’s household income. But that calculation is based on individual coverage for the worker alone, not family coverage, which is much more expensive. That is how the wording of the law has been interpreted by the Internal Revenue Service and the Congressional Joint Committee on Taxation.


The place I work for kept me and a hand full of others full time and cut everyone else to part time to get around it. They had to hire more part timers to make up the lost hours.