What is a Small Employer?

The  definition of Small Employer no longer includes self employed, Partners, Sole Proprietors & S Corps unless there is at least one common law employee.  Since everything will be guaranteed issue for 1.1.2014 it’s OK as the one man shop or husband & wife group can get coverage as individuals regardless of health status.  It should also be a tax write off.  If the business isn’t making that much $$$ there are Tax Subsidies.

Plain English

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With at least ONE non spousal w-2 employee  ♦  Owners ONLY

Call or email us [email protected] if you have questions or need more detail.  Click here for the definition of Employee

Insurance Code §10753   (q)

(1) “Small employer” Health Care Reform —  Non Grandfathered Plans * AB 1083  means either of the following:

(A) For plan years commencing on or after January 1, 2014, and on or before December 31, 2015, any person, firm, proprietary or nonprofit corporation, partnership, public agency, or association that is actively engaged in business or service, that, on at least 50 percent of its working days during the preceding calendar quarter or preceding calendar year, employed at least one, but no more than 50, eligible employees, the majority of whom were employed within this state, that was not formed primarily for purposes of buying health benefit plans, and in which a bona fide employer-employee relationship [Common law employee * Spouses don’t count] exists.

after January 1, 2016employed at least one, but no more than 100, eligible employees,  – Click here for HR 1624 Info

 

the majority of whom were employed within this state, that was not formed primarily for purposes of buying health benefit plans, and in which a bona fide employer-employee relationship exists.

In determining whether to apply the calendar quarter or calendar year test, a carrier shall use the test that ensures eligibility if only one test would establish eligibility.

In determining the number of eligible employees, companies that are affiliated companies and that are eligible to file a combined tax return for purposes of state taxation shall be considered one employer.

Subsequent to the issuance of a health benefit plan to a small employer pursuant to this chapter, and for the purpose of determining eligibility, the size of a small employer shall be determined annually. Except as otherwise specifically provided in this chapter, provisions of this chapter that apply to a small employer shall continue to apply until the plan contract anniversary following the date the employer no longer meets the requirements of this definition. It includes any small employer as defined in this subparagraph who purchases coverage through a guaranteed association, and any employer purchasing coverage for employees through a guaranteed association.

This subparagraph shall be implemented to the extent consistent with PPACA, except that the minimum requirement of one employee shall be implemented only to the extent required by PPACA.

(B) Any guaranteed association, as defined in subdivision (r), that purchases health coverage for members of the association.

(2) For plan years commencing on or after January 1, 2014, the definition of an employer, for purposes of determining whether an employer with one employee shall include sole proprietors, certain owners of “S” corporations, or other individuals, shall be consistent with Section 1304 of PPACA.

[42.usc.18024.b 2 def.employER  (1304) The term “small employer” means, in connection with a group health plan with respect to a calendar year and a plan year, an employer who employed an average of at least 1 but not more than 100 employees on business days during the preceding calendar year and who employs at least 1 employee on the first day of the plan year.]AB 1083  Bill Analysis  6.27.2011.senate   5.3.2011
Item # 5 in
8.30.2012 bill analysis ends choice for self employed to go into exchange as a group.

ORIGINAL….  18) Permits a self-employed individual with specified income to, at his or her discretion, enroll in the Exchange as an individual rather than a small employer.   [This is the 1st of 18 or so bill analysis posted on http://leginfo.legislature.ca.gov ]

Amendment to 10700 w —- (3) On or after January 1, 2014, a self-employed individual who obtains at least 50 percent of annual income from self-employment as demonstrated through personal income tax filings for the current or prior year. To the extent permitted under the federal Patient Protection and Affordable Care Act (Public Law 111-148) and any rules or guidance issued consistent with that law, a self-employed individual whose modified annual gross income is anticipated to be less than 400 percent of the federal poverty level may at his or her discretion seek to enroll as an individual rather than a small employer through the California Health Benefit Exchange.

 

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Child & Related Pages

AB 1672 – (1992 to 2013) Small Group Health Rules prior to Obamacare

Health Insurance Deduction Line 29  for self employed

Schedule C – Line 12 Biz Income or Loss,  Line 29 Health Insurance Premiums,  Line 37 Adjusted Gross Income,   MAGI Income

Home Office Deduction

Self Employed Deduction for S Corp Owners

Details on Obamacare Subsidy and Line 29 deduction

Self Employed – New Definition under Health  Care Reform – Introduction

 

Here’s what they were under AB 1672 – 1992 – 2014

 

 

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