New Final Regulations Provide Transition Relief For Employers From The Affordable Care Act's Employer Shared Responsibility Mandate


On February 10, 2014, the Internal Revenue Service released final regulations pertaining to the Employer Shared Responsibility Mandate (commonly referred to as "Pay or Play") of the Patient Protection and Affordable Care Act (PPACA).  The Pay or Play rules impose penalties on “large employers” that do not offer qualifying coverage to full-time employees who receive subsidized health coverage through state and/or federally-operated healthcare exchanges.  Generally, employers are deemed to be "large employers" for PPACA purposes if they have 50 or more full-time employees (or full-time equivalents). The newly-issued final regulations provide the following transition relief for employers, including large employers:

  • Subject to certain conditions, the Pay or Play rules are delayed until 2016 for employers that have at least 50 but less than 100 full-time employees.
  • Subject to certain conditions, employers that sponsor health plans with non-calendar plan years may delay full compliance until the first day of the plan year that begins in 2015.
  • Employers may use any six-consecutive month period or more in 2014 to determine large employer status for 2015.
  • For 2015, large employers with at least 100 full-time employees or more only need to offer minimum coverage to 70% of their full-time employees to avoid certain Pay or Play penalties. For 2016 plan years and beyond, the 70% figure is increased to 95%.

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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