ACA Penalty Calculator

Minimum Essential Coverage (MEC) plans cover preventive services like vaccinations and screenings to satisfy the part A requirement under the Affordable Care Act (ACA) or 4980H(a). While a Minimum Value Plan (MVP) covers pay at least 60% of the actuarial value of allowed benefits - similar to a bronze-level plan available on a public Exchange. MVP can satisfy the part B requirement under the ACA or 4980H(b).

An Applicable Large Employer (ALE) is a business or organization that has an average of at least 50 full-time employees or full-time equivalent employees (FTEs) based on the preceding year. An applicable large employer may be a single entity or may consist of a group of related entities. If there is a group of related entities, these are referred to as ALE members. ALEs are subject to specific provisions of the Affordable Care Act (ACA), including employer shared responsibility rules and reporting requirements.

A full-time equivalent employee is a combination of employees, each of whom individually is not a full-time employee, but who, in combination, are equivalent to a full-time employee. An employer determines its number of full-time-equivalent employees for a month in the two steps that follow:

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1) Combine the number of hours of service of all non-full-time employees for the month but do not include more than 120 hours of service per employee, and 2) Divide the total by 120

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You can find more information at the IRS ALE page: https://www.irs.gov/affordable-care-act/employers/determining-if-an-employer-is-an-applicable-large-employer

The offer of coverage requirements for ALEs under §4980H are as follows:

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§4980H(a) – ALEs must offer minimum essential coverage (MEC) to at least 95% (or all but 5, if greater) of full-time employees and their dependent children each month. An offer of coverage is not required for spouses.

§4980H(b) – ALEs must offer coverage that provides minimum value AND is affordable to all full-time employees each month. There is not a 5% “margin of error” for §4980H(b) requirements like there is under §4980H(a).

Vtable ACA Compliance Solutions are intended to comply with at least some ACA requirements, to the extent that an employer requests modifications to plan administration or revises plan documentation, the plan may not comply or may not comply fully with the ACA. In addition, Vitable helps employers comply with the ACA and helps employers avoid ACA penalties, but Vitable is not a legal advisor and should recommend that employers consult with counsel regarding compliance with laws and regulations.