Thursday, October 9, 2014

Makes You Want To SHOP Around

If you run a small business, you’ve likely heard of the Small Business Health Options Program, known as SHOP.  As a subset of the affordable care act, the SHOP was created to attempt to assist small businesses in acquiring affordable health care for their employees.  While the intentions are good, many small businesses might find it difficult to participate in the SHOP and receive the tax credits that are part of the program.
Here are a few details that are important to know regarding the SHOP in Illinois for 2015:
·       In order to participate in the SHOP, you must have fewer than 50 Full time equivalent (FTE) employees.
·       For 2015, the employer can only offer one qualified SHOP plan to its employees.[1]
·       In order to take advantage of the tax credit that is available, the following criteria must be met:
o   You must have less than 25 FTE employees.
o   Average earnings for each employee must be less than $50,800.[2]
o   The employer must pay at least 50% of the Employee Only portion of the premium.
o   70% of the employees must participate.
o   Coverage must be made available to all employees.[3]
o   The tax credit requires SHOP Marketplace coverage.
o   If a tax credit is qualified for, it is available for 2 consecutive years and can be up to 50% for for-profit companies and 35% for not-for-profit entities.
As you might conclude from the requirements, there are many small businesses that don’t qualify for a tax credit or for participating in the SHOP at all.  If you’re a very small company with two owners operating the entity and no other employees, the SHOP is really not an option. 
You will be hearing a lot about the SHOP in the coming weeks as we approach Open Enrollment.  While the SHOP might provide a solution for some companies, unfortunately, the hype will disappoint far more as they realize the caveats that come with qualifying for the tax credits. They are not realistic for their circumstance.
Therefore, before you get too excited about the SHOP, it might be wise for you to shop around.  The market, while inflated as a result of new coverage requirements and taxes, provides other alternatives for those that don’t fall into the mold required by SHOP.  And, at least company paid premiums for group coverage are still tax deductible expenses.[4]


[1] In 2016, it is projected that there will be more choice available for each employee.
[2] The following persons would not be included in computing the number of employees and used in the earnings computation:  Owner, Partner, Shareholder of an S Corp., Owner of more than 5% of another business, family.  The income qualification limit is subject to cost of living adjustments on an annual basis.  The limit was $50,000 in 2014.
[3] This is a requirement to participate in the SHOP, notwithstanding the eligibility for a tax credit.
[4] Company paid premiums for Individual coverage (Not part of a group plan) are NOT tax deductible.

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