Employers with over 50 employees

ACA Mandate & Penalties

Major Points of the  Employer Shared Responsibility – Mandate Provisions

Health Care Reform includes the employer mandate – shared responsibility mandate provisions, which require applicable large employers  (IRS Website to determine if you are an ALE) to offer health coverage to full-time employees and their dependents. Those that do not offer coverage might be subject to the employer shared responsibility payment.

I’ll grant you, this can be quite confusing.  See our other pages on the mandate, ale and the penalties.


Employer Mandate for Health Insurance ACA 4980 h


  1. These provisions apply to applicable large employers, which includes tax-exempt and federal, state, local and Indian tribal government employers. You’re an applicable large employer if you have 50 or more full-time employees, including full-time equivalents.
  2. If you have fewer than 50 full-time employees, including full-time equivalents, you are not an applicable large employer and are generally not subject to these  provisions. However, you are subject to the rules for large employers if you have fewer than 50 employees, but are a member of an ownership group that has 50 or more full-time equivalent employees,
  3. You are subject to the payment if any employee receives the premium tax credit from Covered CA and any one these conditions apply. Your organization:

failed to offer coverage to full-time employees and their dependents

offered coverage that was not affordable

offered coverage that did not provide a minimum level of coverage – Bronze

  1. You do not report or include an employer shared responsibility payment with any information return you file.
  2. Some of the provisions of the Affordable Care Act only affect your organization if it’s an applicable large employer. An ALE is generally one with 50 or more full-time employees, including full-time equivalent employees.   The vast majority of employers will fall below the ALE threshold number of employees and, therefore, will not be subject to the employer shared responsibility provisions.

    • Applicable large employers have annual reporting responsibilities. You will need to provide the IRS and employees information returns concerning whether and what health insurance you offered to your full-time employees.
    • If you’re an applicable large employer that provides self-insured health coverage to your employees, you must file an annual return reporting certain information for each employee you cover.
    • ALEs must either offer minimum essential coverage that is affordable and that provides minimum value to their full-time employees and their dependents, or potentially make an employer shared responsibility payment to the IRS.
    • Learn more about the employer shared responsibility provision.
    • You may be required to report the value of the health insurance coverage you provided to each employee on their Form W-2.
    • If you’re an applicable large employer with exactly 50 employees, you can purchase affordable insurance through the Small Business Health Options Program (SHOP).  Or directly with an Insurance Company, no charge for our services.   See button above or below to get a quote.

      For more information, see the Affordable Care Act Tax Provisions for Employers

Employer Mandate Flow Chart – Kaiser Foundation

Explanation and solution from Optimed 

to avoid the penalties

OptiMed Health Plans is a national Third Party Administrator, bringing service to its proper dimension. We provide a complete range of benefit products, and administrative services to both corporate and public entities, including the States of Florida and Ohio. We work directly with consultants to simplify, standardize and automate time-consuming human resource functions. Our services can directly impact a client’s bottom line by the freeing up internal resources removing the need for expensive benefit management systems, improving employee satisfaction and thereby increasing employee retention, while helping to reduce cost. We are dedicated to service and reliability. Our staff is professional, knowledgeable and efficient.

No charge for our broker service and consultation  42 U.S. Code § 18021


CA has an individual penalty

Our webpage on "affordable" coverage

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Guidelines – ACA Full Time Employee Definition

For the EmployER Mandates – In general   The term

“full-time employee” means,

with respect to any month, an employee who is employed on average at least 30 hours of service per week. 26 USC § 4980H   Compare with the  definition of employee –  under California AB 1083 to comply with Health Care Reform.

Can you make them 1099 independent contractors and not employees?

Art Gallagher Health Care Reform FAQ's

Health Care Reform FAQ's

Health Care Reform Explained

FAQ’s, Resources & Links

Moulder Law Relief, Confusion Associated with §4980H(a) Transition Relief

ADP.com Final Regulations, Delays & Transitional Relief


On Feb. 10, 2014, the IRS and Treasury issued final regulations on the Employer Shared Responsibility provisions under section 4980H of the Internal Revenue Code. More information is available on the employer shared responsibility page. The following questions and answers provide helpful information about the guidance:

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