SHOP Covered CA for Small Business Program
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As I see it, the main advantages to CCSB:
- Small Biz Health Care Tax Credit, if your average wage is low enough. However, either way you still get the Section §106 Health Insurance Premium Deduction and your employees can get the POP §125 deduction for their contribution.
- Employee ONLY plans, (scroll down) so the wife and kids can get Covered CA subsidies – complementary calculation
Please note that self-employed that were eligible under AB 1672 must now have a common law employee (not spouse) to qualify. Self employed can get coverage individually, guaranteed issue and still take a tax deduction, line 29 1040. Individuals that don’t have employer coverage may be eligible for tax credits.
Proofs & Documents to Qualify for Coverage
Please check the SHOP employer application page 2, for the documents that are needed to show that your business qualifies for coverage. Rather than list all the employees on page 4, just have each employee complete an enrollment form, or include the information in your census
See also our Administration Page
- Employees who have dependents seeking subsidy assistance through the individual exchange cannot qualify.
- Spouse/parents enrolled in an employer group ACA qualified plan in most cases disqualifies the subsidy eligibility – Family Glitch – 9.66% Rule
- Most employers do not contribute to the dependent portion of the premium, but because the offer the coverage the dependents technically have “Access” to a ACA qualified plan.
- Dependent coverage is perceived as “unaffordable” to the employee; result = low to no dependent participation
- Why have an employer offer a benefit that is not utilized and unintentionally penalizes??
- Implement an “employee only” plan; dependents do NOT have “Access” thereby receiving subsidies. 9.17.2015 Covered CA Email
- Covered California for small business filed their contract to support this feature.
- If the dependents of your employees qualify for Covered CA subsidies – FREE Quote and Subsidy Calculation and the employer is not contributing, then we need to get you into a SHOP program and write it up as employee only, by NOT selecting dependents on page 3, step 2 question 11 of the SHOP employer application.
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Fact Sheet 2 pages pdf