Excellus Bluecross BlueShield logo
Login | Register | Forgot Username | Forgot Password
Program Offerings
By Phone
By Email
By Mail
Visit Us In-Person
News & Updates
Print Forms
About Us
Compliance Notices
Broker News | March 2015 | Vol. 10 No. 2
Broker News | March 2015 | Vol. 10 No. 2

Health Reform Update: Reminder to Employers with 51-100 FTEs

About the Employer Mandate

Health Care Reform’s Employer Mandate currently requires employers with 51 or more full-time equivalent employees to pay a penalty if they don’t provide minimum value, affordable health insurance to their full-time employees and dependent children. Employers with 51-99 FTEs received transitional relief from this mandate until 2016. Upon renewal starting January 1, 2016, however, employers with 51 or more employees will be required to comply with the Employer Mandate.

Under the Employer Mandate, “full time” is defined as an employee who works on average 30 hours or more per week. Those employers who do not offer coverage must pay a penalty of $2,000 per full-time employee (not including the first 30 employees). If the employer has never offered health insurance to their employees in the past, they will be required to offer insurance or pay the penalty.

Expansion of Community Rated Pool

The Affordable Care Act also changes groups covered by the current community rating model from employer groups with 1-50 full-time eligible employees to employer groups with 1-100 total employees (note: groups of 1 cannot be sole proprietors or primary family coverage only). We’ve begun identifying groups that may be impacted by the proposed community rating change for renewals on or after January 1, 2016. 

We are working with our legal team and the Department of Financial Services (DFS) to obtain clarification on how employees should be counted and other guidance. Rest assured that we are committed to gathering feedback from our broker partners as we go through the planning process. We will also be sending regular communications starting this summer.

Thank you for your continued patience as we work to fully understand the impact of this coming change.


Home     News & Updates    Print Forms    About Us    Fraud & Abuse    Glossary    Accreditations   
Language Assistance and Non-Discrimination Notice

Copyright © 2018, Excellus BlueCross BlueShield, a nonprofit independent licensee of the Blue Cross Blue Shield Association. All rights reserved. View our Web Privacy Policy for information on how we protect your privacy. Use of this site indicates your acceptance of our Terms of Use. Follow this link to view our 31 county New York State service area. You will need Internet Explorer or Firefox to use the secure features of this site.