Healthcare Reform - Employee Calculations

© 2013. All rights reserved. Rea & Associates, Inc.

Bracing for Impact: What you need to know about health care reform

Q & A from Webinar Presentation March 26, 2013


Employee Calculations Questions related to

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If temporary agency employees work only for the entity and the entity controls the schedule and the task, will they have to be offered insurance?

If the temp agency employs over 50 full-time employees, and the employees you are referring to are full-time common law employees of the temp agency, absolutely, they will need to be offered coverage.

The temp agency can elect to pay one of penalties if they do not “play.”

Yes.

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In the case of an individual with majority ownership in multiple entities, is it most likely that the FTE's will be aggregated regardless of entity type and structure?


If you have a part-time employee who is scheduled for 25 hours per week, but picks up extra hours and goes over 30 hours, what happens to the status of insurance?

If this is a regular occurrence, and they are full-time after the measurement period testing that applies to them, they will be full-time under ACA and will need to be offered insurance.

If you have proper measurement periods in place, an occasional 40 hour week or 130+ month will not be a problem. The key there is you have to have the proper policies in place!

For the large employer count, look at who the common law employer is. A common law employer/employee is a very fact intensive area.

Only employers whose businesses are part of commonly controlled groups have to aggregate employees.

If you know which EIN is the common law employer of the workers, and you know how those EINs are related, then you can properly aggregate groups for Large Employer testing.

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What about multiemployer collective bargaining agreements? We have six different multiemployer plans that provide health care. Do all these employees count for the large employer count?


Can you discuss Amish employees needs briefly?

Amish employees (but not employers) have a religious exemption from the requirement to buy health care the same as they have in several other areas of the law. There are existing rules on how this works in other areas which the ACA has adopted.

Employers should offer coverage and obtain a waiver from their Amish employees.

Amish employers should offer coverage to their employees, assuming they are large employers under ACA.

Remember that it takes a full-time worker going to the exchange and buying coverage with a subsidy to trigger the penalties – an Amish employee should not do that (unless they really want health care coverage and are willing to risk the non-tax related consequences I suppose).

Note: The religious exemption must be renewed by minors that come of age (18, I believe). Employers should track this and obtain new waivers accordingly.

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We are a trucking company and have never needed to track hours because we do not fall under the FLSA. How will they measure hours for a trucker?

By actual hours worked. If they are not paid on an hourly basis (but by the job), there are the 8 hours/day and 40 hours/week safe harbors.

This might be a great time to talk to an external company that has stand-alone options for hour tracking that are proven and low cost.

The IRS is soliciting comments on how to deal with folks that are obviously full-time (like pilots), but that have some restrictions on their workday due to other areas of the law. Truckers, I believe, have similar rest period requirements.

If that’s all they are employed for, it’s probably not a problem. Remember, there is a 90 day administrative waiting period that you can build into your policies.

You don’t have to provide, nor can you be penalized, for not providing coverage to anyone during their first 90 days.

If those workers will be employed more than 90 days, so long as you have the proper measurement period established and they are otherwise not hired to be full-time, you will be ok.

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What happens during elections, when the Board of Elections hires employees for approximately 1 and 1/2 months, 10+ hours day?


If there are five restaurants under one common holding company with more than 50 people combined, are they considered a large employer? If yes, what if they were to each be their own separate company, would it still apply?

In both situations, it sounds like we have common ownership. You would aggregate the employees for purpose of Large Employer testing and it sounds like you would be a large employer.

For penalty testing, they would each be considered on a separate company basis.

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Are seasonals designed as 120 days or can they be defined differently if stated as such by our organization?

Seasonal workers are 120 days maximum, for now, no real flexibility.

The IRS has solicited comments on other ways of providing a seasonal safe harbor.

For purposes of Large Employer testing, you look at actual hours by month – measurement periods do not apply/are not applicable.

For penalty testing, to see if someone is full-time or not, you are correct that it is over the whole measurement period.

Note: If you hire someone intending them to be full-time, the measurement period rubric doesn’t apply to them – they are simply considered full-time.

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We only have to be concerned about part-time/full-time if they exceed full-time over the entire measurement period, correct?


Need Clarification? contact: Joe Popp, JD, LLM

614.923.6577 [email protected]

Healthcare Reform - Employee Calculations

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