HR Support

As a business owner, you have learned to wear many hats, of which none may be more important than meeting the deadlines and rigorous compliance requirements that come with managing employees and sponsoring a benefit program. Missing just one deadline can be costly. We make life easier for employers and their HR teams, helping them to avoid being blindsided by the constantly changing landscape of regulatory compliance. 

Here are some of the compliance and administration tasks we assist with.

Highlights of the ACA*

The Affordable Care Act, aka Obama Care, was first established in 2010. It is extensive healthcare reform that mandates employers with 50 or more full-time equivalent employees offer health coverage to their employees. Today, the law continues to evolve, increasing its complexity. Castle Group Health works diligently to stay on top of ACA requirements and all healthcare reform to help businesses ensure compliance and avoid IRS penalties. Here’s what you need to know.

Your employer sponsored benefits must comply with the “Essential Benefits” of ACA. Specifically, to be in full compliance with the law, your insurance policy must cover at least 60% of the costs these essential benefits. These benefits include:

  • Ambulatory patient services
  • Emergency services
  • Hospitalization
  • Maternity and newborn care
  • Prescription Drugs
  • Mental health and Substance —Abuse disorder services
  • Rehabilitative and habilitative services and devices
  • Pediatric services, including oral and vision care
  • Preventive and wellness services, and chronic disease management

Other services ensuring your compliance with the ACA include:

  • Assist with tracking hours
  • Ensure eligible employees are offered coverage
  • Assist with the reporting process and necessary tax forms
  • Handle employee notices
Employers who have more than 50 full-time equivalent employees must offer those employees benefits that pay for 60% of the minimum essential benefits. If you are in non-compliance in 2025, you will incur a penalty of $2,900 (down from $2,970 in 2024) per year multiplied by the number of full-time employees, and excludes the first 30 employees. Additionally, the penalty is increased each year by the growth in insurance premiums. However, note you may also incur a penalty when at least one of your employees receives a premium tax credit in the Health Insurance Marketplace (Exchange).

The Affordable Care Act (ACA) significantly changed how health insurance plans are offered and underwritten:

  • There is no longer a pre-existing condition clause. In other words, insurance companies can not increase rates or deny coverage because of a pre-existing condition.
  • Employee dependents can remain on your policy until they turn 26 years old.
  • Insurance companies can not consider gender when setting rates.
  • Employer renewals must be based on the same rates as new business.
  • The waiting period for employer benefits should not exceed 90 days.

*This information provide applies to employers. If you are an individual seeking information on how healthcare reform affects you, click here.