Affordable Care Act

The Affordable Care Act (ACA) is a piece of legislation that was developed to help insure health benefits to millions of Americans. This Act has become a very contested piece of legislation. Clemson Extension does not take a position and will remain objective on this Act. Clemson Extension will provide information and material that allow consumers, self-employed individuals and their families, small businesses, and farms to make informed decisions about the requirements of the Affordable Care Act (ACA).

With the complexity of this legislation additional information continues to be released by U.S. agencies and departments involved with regulating the ACA. As new information is made available this website will continue to grow and update previously released material. All of the information and materials found on this site were current as of the date they were prepared and released. We will strive to update material in a timely manner as new information comes forward. 

Clemson Extension always recommends that you contact your legal, tax, and other professional advisors prior to taking any steps to meet the requirements of the ACA as this is a very complex act and each individual, farm, or business’ situation is unique. 

If you have any questions or find that any information needs to be updated, please feel free to contact Adam J. Kantrovich, Ph.D. at akantro@clemson.edu.

General & Tax Information

• Large Employer Reporting
  • 1094-C, Transmittal Form of Employer-Provided Health Insurance Offer and Coverage (IRS)
  • 1095-C, Employer-Provided Health Insurance and Coverage Insurance Provided to Employee (IRS)
• Buying Health Insurance (Long, Michigian State University Extension)
• Information Reporting by Providers of Minimum Essential Coverage (IRS)
• IRS Affordable Care Act (ACA) Tax Provisions and Topics Webpage (IRS)
• IRS Q&A on Incorrect Forms 1095-A and the Premium Tax Credit (IRS)
• February 12th, 2014 Affordable Care Act Update & Final Regulations (IRS)
• The Affordable Care Act Law (U.S. Dept. of Health & Human Services)
• Affordable Care Act Tax Provisions (IRS)
• Small Employer Health Care Tax Credit (Adam J. Kantrovich, Clemson University Extension)
• Kaiser Family Foundation, Information about health care issues
• IRS Webinars 

Farm and Business Mandate Requirements and Information

• Employer Shared Responsibility Payment Estimator (Dept. of the Treasury, IRS, 7/11/16)
  • The estimator makes a number of assumptions that do not consider a number of Seasonal employee/worker, Variable Hour employee/worker, Look back Measurement Period, and Rules of Parity regulations. Due to this the estimator may calculate a significantly higher penalty then would actually be required to pay.
• IRS Tax Tips - Health Care Tax Tips (IRS)
• Get to Know the Health Care Law’s Employer Shared Responsibility Payment, June 17, 2015 (IRS)
• IRS Tax Tip: The Health Care Law and Employers: The ACA Basics for Applicable Large Employers, June 10, 2015 (IRS)
• IRS Tax Tip: ACA and Employers: How Seasonal Workers Affect Your ALE Status, June 3, 2015 (IRS)
• Determining if you are an Applicable Large Employer (IRS)
• FTE Excel Spreadsheet Calculator for Employers (Kantrovich, Clemson University Extension & Schweikhardt, Michigan State University Extension)
• Worksheet for Determining Employer Status (Schweikhardt, Michigan State University Extension & Kantrovich, Clemson University Extension)
• ACA Employer Shared Responsibility Payments Article (Kantrovich, Clemson University Extension & Schweikhardt, Michigan State University Extension)
• ACA Q&A for Employers (Revised June 27, 2014) (Kantrovich, Clemson University Extension & Schweikhardt, Long, Michigan State University Extension)
• ACA Q&A for Self-Employed (Kantrovich, Clemson University Extension & Schweikhardt, Long, Michigan State University Extension)
• ACA Q&A for Individuals and Families (Kantrovich, Clemson University Extension & Schweikhardt, Long, Michigan State University Extension)
• ACA Q&A about the Health Insurance Marketplace (Kantrovich, Clemson University Extension & Schweikhardt, Long, Michigan State University Extension)
• Determining if you are an Applicable Large Employer (IRS)
• Farm and Small Business Employee Notification Mandate by Oct. 1, 2013 article (Adam J. Kantrovich, Clemson University Extension)
• Affordable (Health) Care Act (ACA) Reprieve of one year. Starting now will prevent pain later! (Adam J. Kantrovich, Clemson University Extension)
• U.S. Department of Labor Action Statement of Employer Responsibility for Employee Notification by October 1, 2013
• Determining Full-Time Employees for Purposes of Shared Responsibility for Employers Regarding Health Coverage (4980H), IRS Notice 2012-58
• U.S. Department of Labor FLSA Required Employee Health Care Coverage Notification Information Page
  • ENGLISH: U.S. Department of Labor Employee Notification Template for Employers that provide Health Care Benefits 
  • SPANISH: U.S. Department of Labor Employee Notification Template for Employers that provide Health Care Benefits 
  • ENGLISH: U.S. Department of Labor Employee Notification Template for Employers That DO NOT provide Health Care Benefits
  • SPANISH: U.S. Department of Labor Employee Notification Template for Employers That DO NOT provide Health Care Benefits 

Individual Mandate Requirements and Information

• Individual shared Responsibility Payment Estimator (Dept. of the Treasury, IRS, 7/11/16)
• ACA Individual Shared Responsibility Payment Exemptions (Dept. of the Treasury, IRS, 7/11/16)
• My Smart Choice Health Insurance Workbook 
• Instructions for filling out the IRS Form 8965 that contain worksheets to figure any 2014 shared responsible payment that is due (Dept. of Treasury 3/10/15)
• IRS Form 8965 for Healthcare Exemptions for the Individual Shared Responsibility Payment (Dept. of Treasury 3/10/15) 
• Fact Sheet: Individual Shared Responsibility for Health Insurance Coverage and Minimum Essential Coverage Proposed Rules, (Dept. of Treasury 1/30/13)

Federal Phone Numbers for Employers

There are now 3 separate phone lines to help small employers get information about health insurance coverage for their employees. The Federally-facilitated SHOP Call Center line is available to help employers, employees, assisters, and agents and brokers get assistance with the Federally-facilitated SHOP Marketplace; the Cancellation Call Center line is available for employers whose grandfathered plans have been canceled to get help understanding their options; and the ACA Employer Call Center line is available for employers to get help understanding their responsibilities under the Affordable Care Act. Call center representatives are available to help Mon - Fri, 9 a.m. to 7 p.m.; Sat - Sun, 9 a.m. to 5 p.m. EST.

• The General SHOP Call Center line: 1-800-706-7893 TTY: 711
• The Cancellation Call Center line: 1-866-837-0677 TTY: 711
• The ACA Employer Call Center line: 1- 800-355-5856 TTY: 711

Small employer health insurance tax credit for farmers and businesses

Small employers offering health insurance may be eligible for a tax credit through 2015 if certain criteria are met.

Posted on August 16, 2013 by Adam Kantrovich, Clemson University Extension

Since 2010 the small employer health insurance tax credit (Code Section 45R) has been available. For tax years 2010 through 2013, businesses that pay over half the cost of health insurance under a qualifying plan and have 10 or fewer full-time equivalent employees (FTE) who average $25,000 or less in wages can receive up to 35 percent of their qualified premiums as a general business credit. The credit phases out 6 2/3 percent for each employee over 10 and 4 percent for each $1,000 of average wages received over $25,000. It is completely phased out at 25 FTE or $50,000 average wages or any combination of reductions that add up to 100 percent reduction. For example, with 19 employees and $35,000 average wages the reduction is (19 – 10) multiplied by 6 2/3 percent = 60 percent reduction and [($35,000 - $25,000)/$1,000] multiplied by 4 = 40 percent reduction for a total reduction of 100 percent of the tax credit which leaves zero credit to the employer.

It’s important to note that as the definition of farmer varies in the tax code, the meaning of the term “employee” for the Section 45R credit is one who works 2,080 hours (one FTE) while the employee meaning for the shared responsibility requirements after 2013 or the penalty tax calculations for health insurance is an average of 30 hours per week.

FTEs generally do not include owners, family members, dependents or seasonal workers (less than 120 days). Leased employees do count for calculating FTEs. Average wages are rounded down to the nearest thousand dollars. Health insurance is normally considered an ordinary and necessary expense and is, therefore, deductible. Any credit received will reduce the business expense by the amount of the credit. Only premiums paid for health insurance under a qualifying plan or arrangement for employees may be used in calculating the credit. The credit is also reduced if the employer premiums are more than the average premium for the small group market. In Michigan (for 2012) that amount was $5,335 for single coverage and $12,936 for family coverage. Expect these to be a little higher in 2013.

The maximum credit increases to 50 percent for tax years beginning in 2014 through 2015. Some restrictions change such as the employer must participate and purchase the health insurance coverage through the state insurance exchange instead of working through an insurance agent to get the credit. The credit expires after 2015. After 2013 the $25,000 average annual wage amount may be adjusted for inflation. See IRS Form 8941, Credit for Small Employer Health Insurance Premiums, and the accompanying instructions for specific information.