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V O L . X X I N O. X X I S E P T E M B E R 2 1 , 2 0 1 5 26 T he one-year grace period that delayed full implementation of the Affordable Care Act's employer shared responsibility rule, or the employer mandate, is coming to an end. In 2015, firms with 100 or more full-time-equiv- alent employees had to insure at least 70% of their full-time workers. For 2016, the mandate requires all businesses with 50 or more full-time equivalent employees to provide health insurance for at least 95% of their full-time employees, and dependents up to age 26, or pay a penalty. Employers must file information reports with the Internal Revenue Service with regard to coverage offered, or not offered, and must provide statements to their full-time employees about its offers of health coverage. Because this is a new program, short-term relief from penalties is available as employers figure out appropriate compliance procedures. For most employers, this is more of a paperwork headache than anything else. "Most large employers, and even most mid-size employers, already offer insurance that is in compliance with the ACA," says Emily Brostek, executive direc- tor of the Augusta-based nonprofit Consumers for Affordable Health Care. "e vast majority of big firms offer good, comprehensive coverage. So there's not a ton of larger employers that have to make a change." Changes in 2016 Nationwide, 96% of firms with 50 or more full-time employees already offered coverage to full-time workers prior to the ACA, according to treasury.gov. Reflecting that number, most firms in Maine with 50 or more employees already offer health insurance. According to the Kaiser Family Foundation, in 2013, 97% of Maine's 7,912 private sector establishments — including incor- porated for-profits and nonprofits, but not including unincorporated private sector firms or government establishments — offered health insurance. However, some mid-sized employers find the issue is complicated by the threshold of 50-full-time-equiv- alent employees, as well as the ACA definition of full- time as 30 hours per week rather than the usual 40. It's not a difficult tally for many employers, says Edward Feibel, a benefits specialist at the law firm Eaton Peabody, who, together with his partners, Leslie Hallock, David Wakelin and Anne O'Donovan, helps employers navigate the law. "e employers I deal with have pretty stable work- forces," says Feibel. "ey've already made their adjust- ments, in terms of how many hours of work they're hiring people for. ey've adjusted budgets accordingly." But for some industries, notably those dependent on part-time or seasonal labor, it's a whole lot of arithmetic. Healthcare.gov explains how to tally: e employer first counts its employees working an average of 30 or more hours per week as full-time employees. If the employer has employees working less than that, it determines the number of full-time equivalents by multiplying part-time hours by 52 weeks, then dividing by 12 months. "It's very difficult to make a lot of the calculations," says Augusta-based Maine Restaurant Association executive director Greg Dugal. "A lot of payroll com- panies have thankfully stepped up to figure out what needs to be accomplished. Reporting after the fact is still cumbersome, and it's sizeable expense to keep yourself in compliance. Certain industries are more impacted by calculation woes than others. Hospitality and retail industries, with large numbers of seasonal and part-time workers, fall into that category. Even colleges and universities, with adjunct faculty, are affected. "A lot of small colleges never really thought about adjuncts getting benefits," says Hallock. "And now, all of a sudden, they have to." Tipping the balance Employers with fewer than 50 employees are not sub- ject to the mandate. But for workforces with approxi- mately that number, a new hire could tip the balance. "at 50-employee threshold is a real concern for folks," says Curtis Picard, executive director of the Augusta-based Retail Association of Maine. "ey feel it will be a hindrance when you bump up against the threshold." Some affected companies that don't offer health insurance, or offer inadequate insurance, are calcu- lating whether it's more cost-effective to comply with the law or pay a tax penalty. Insurance plans must meet a "minimum value" standard, which means a plan can't cost more than 9.5% of employee household income for employee- only coverage (employers can use employee income statements to stand in for household income). Employers must also contribute at least 60% of the cost for individual minimum essential coverage. According to the National Center for Policy Analysis, health benefits are a significant expense for U.S. employers and a substantial portion of work- ers' total compensation. e Congressional Budget Office estimates that the required coverage for an individual will cost $5,800 a year or more in 2016 — the equivalent of an additional $3 an hour "minimum health wage." Family coverage could cost more than twice that. e Kaiser Family Foundation's annual survey of employer health benefits found the average cost of an employee family plan was $16,351 in 2013. is compares with the government's penalty: $2,000 for each full-time employee beyond the first 30. For employers that do provide coverage but don't provide coverage meeting minimum-value require- ments, the penalty is the lesser of $3,000 per full- time employee receiving subsidies, or $2,000 per full-time employee (minus the first 30). Emily Brostek, executive director of Consumers for Affordable Health Care, says fears that companies might shift employees to part-time status to avoid buying health insurance have not been borne out. P H O T O / R U S S D I L L I N G H A M Are you ready? ACA employer mandate moves full steam ahead B y L a u r i e S c h r e i b e r F O C U S

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