Small Group (50 or Fewer Employees) Insured Plans and PPACA
(Updated April 2014)
PPACA brings numerous responsibilities and options to employers. Below is a summary of the PPACA provisions that apply to group health plans and whether the provision applies to insured small group plans provided inside and outside the SHOP exchange.
Note: For 2014 and 2015 a group is considered “small” for the insurance market requirements of PPACA if the group has 50 or fewer employees. Beginning in 2016, a group will be considered “small” for the insurance market requirements if the group has 100 or fewer employees. (In most states part-time employees count pro rata toward full-time equivalent employees using the same method as the employer shared responsibility/play or pay requirement.)
In contrast, for purposes of the employer shared responsibility/play or pay requirement, for 2015 an employer generally will not be considered “large” unless it has 100 or more full-time or full-time equivalent employees. Beginning in 2016, an employer will not be considered “large” for purposes of the employer shared responsibility/play or pay requirement unless it has 50 or more full-time or full-time equivalent employees.