Affordable Care Act Compliance Calculator

Since the inception of the Affordable Care Act (ACA), its ever-changing rules and regulations have surpassed 20,000 pages.
Are you in compliance with them?

Number of ACA full-time and full-time equivalent employees employed on average during the previous calendar year:

As a small employer you may be subject to employee-coverage rules and should be using the standard measurement period to determine your full-time employees.

As an applicable large employer (ALE), you are subject to the employer mandate and should be measuring your employees to determine whether they are ACA full-time, using the look-back measurement method or the monthly measurement method.

Patient room

How many full-time employees do you have in a month?

Do you offer minimum essential coverage to 95% of your full-time employees and their dependents?

Yes
No

Congratulations! You are on your way to ACA compliance because you offer minimum essential health coverage to at least 95% of your full-time employees and their dependents.

If you do not offer health insurance to at least 95% of your full-time employees and their dependents, and one or more of your employees qualifies for a subsidy, opting for coverage through the exchange, you could be fined $2,320 per year for the total number of full-time employees – not counting the first 30 – for the months when the employee(s) received a premium subsidy. This fine would be assessed on a monthly basis.

Possible monthly fine: $0

Does your plan pay at least 60% of covered health costs?

Yes
No

Congratulations! Your plan covers 60% of covered health costs and is one step closer to meeting the employer mandate requirements.

If your plan does not pay 60% of covered health costs, and one or more of your employees qualifies for a subsidy and opts for coverage through the exchange, you could be fined $3,480 for each month for each employee who received a subsidy. This penalty would not exceed the fine for not offering minimum essential coverage to at least 95% of employees and their dependents.

Possible monthly fine: $0

Must any employee pay more than 9.5% (as annually adjusted) of their income for employee-only coverage?

Yes
No

It looks like you have employees who could be eligible to receive subsidies if they decide to buy coverage through the exchange, if they pay more than 9.5% (as annually adjusted) of their household income, as calculated using one of the three affordability safe harbors allowed by the IRS. As the employer, you could face a $3,480 penalty for each employee receiving subsidies for coverage. This penalty would not exceed the fine for not having offered minimum essential coverage to 95% of full-time employees.

You offer affordable health insurance. Coverage under an employer-sponsored plan is considered affordable if an employee’s required contribution to the plan for employee-only coverage does not exceed 9.5% (as annually adjusted) of the employee’s household income, as calculated using one of the three affordability safe harbors allowed by the IRS.

Total number of full-time employees: 0

Number of employees receiving subsidies:

Potential penalties for employers who offer insurance that does not meet the affordability requirement could cost:

Possible monthly fine: $0

To learn more about how Paycom can help you navigate ACA, request a demo.