Affordable Care Act


As an employer, you play a big role in carrying out health care reform. You have a lot to know, much to think about, and many choices to make. Only by understanding your choices can you decide what’s best for your workers and your business. This guide will help you understand the health care reform rules that affect you. Keep in mind that the law is complex and the rules are  still changing.

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The Affordable Care Act (ACA) Imposes a penalty on large employers that do not offer minimum essential coverage to substantially all full-time employees and their dependents. Large employers that offer coverage may still be liable for a penalty if the coverage is unaffordable or does not provide minimum value. This employer mandate provision Is often referred to as “employer shared responsibility” or “pay or play” rules.

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Obama Signs PACE Act

NAHU is pleased to share with you that President Obama has signed into law the Protecting Affordable Coverage for Employees (PACE) Act. The House of Representatives passed H.R. 1624 on September 28 through voice vote and the Senate, through unanimous consent, passed the legislation on October 1. NAHU was a leading advocate for this legislation, along with its partners in the 50-100 Coalition, and we would like to thank everyone involved for their efforts to pass this legislation. 

The PACE Act repeals the mandated small-group expansion from groups of up to 50 employees to groups of up to 100 employees that was to go in to effect on January 1, 2016. This law gives states the flexibility to determine the size of their small-group market instead of being forced into the national standard. NAHU has long been concerned that the combination of the new compliance requirements and the regulations for the new group size would cause dramatic change to the insurance policies of medium-sized employers, and we have continued to advocate for the enactment of the PACE Act to prevent this type of market disruption. 

NAHU is now shifting our focus to the states as they work to implement this new law. As stated above, the PACE Act defines small groups as those with up to 50 full-time equivalents; however, states now have the ability to set their own definition of small group as long as the definition is no less than 50 and no more than 100. Some states took action early and have already passed legislation that mirrored the ACA and expanded the definition of small group to groups of up to 100 effective January 1, 2016. Those states will expand to 100 unless action is taken to pass legislation to define small group as up to 50. For the majority of states that took no action regarding the definition of small group within their borders, we await confirmation from the departments of insurance and legislatures as to whether the states will accept the new federal standard or if they will take action of their own to expand the definition of small group of up to 100. 

As we await the decisions of the states, NAHU will continue to work with the carriers, state legislators and state insurance commissioners on implementation. We will share a listing of state decisions regarding small-group size as these determinations are confirmed.

Medical Mutual of Ohio
United HealthCare
Self Funded Plans

Lincoln Financial
American Equity

Employers Dental Trust

Medicare Health Plans
Medical Mutual of Ohio
United Health Care
The Health Plan

Employers Vision Trust
Vision Service Plan

Long Term Care
John Hancock
Mutual of Omaha

Sun Life
North American
Ohio National
West Coast Life
U.S. Life
Lincoln National