Affordable Care Act - Individuals

Are wages that are not paid in cash, such as fringe benefits, subject to Additional Medicare Tax?

Asked Thursday, November 21, 2013 by an anonymous user

CPA Answer:

Yes, the value of taxable wages not paid in cash, such as noncash fringe benefits, are subject to Additional Medicare Tax, if, in combination with other wages, they exceed the individual’s applicable threshold.
Noncash wages are subject to Additional Medicare Tax withholding, if, in combination with other wages paid by the employer, they exceed the $200,000 withholding threshold.
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Affordable Care Act - Small Biz

Is third party sick pay used in the calculation of the $200,000 threshold?

Asked Thursday, November 21, 2013 by an anonymous user

CPA Answer:

Yes. Wages paid by an employer and by the third party need to be aggregated to determine whether the $200,000 withholding threshold has been met.
The same rules that currently assign responsibility for sick pay reporting and payment of Medicare tax based on which party is treated as the employer (that is, the employer, the employer’s agent, or a third party that is not the employer’s agent) apply also to Additional Medicare Tax.
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Affordable Care Act - Small Biz

What types of benefits will be covered in the new health plans?

Asked Thursday, November 21, 2013 by an anonymous user

CPA Answer:

Generally, all health plans that are qualified under the Affordable Care Act will include minimal essential benefits such as: Ambulatory patient services, such as doctor's visits and outpatient services, Emergency services, Hospitalization, Maternity and newborn care, Mental health and substance use disorder services, including behavioral health treatment, Prescription drugs, Rehabilitative services and devices, Laboratory services, Preventive and wellness services and chronic disease management, Pediatric services, including oral and vision care.
While the Affordable Care Act requires coverage for each of these categories, the law does not define the specific services that must be covered or the amount, duration, or scope of services.
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Affordable Care Act - Small Biz

What is the penalty for Large employers who do not comply?

Asked Thursday, November 21, 2013 by an anonymous user

CPA Answer:

Larger employers (with more than 50 employees) will be required to provide insurance or face a tax penalty of $2,000 per employee, starting with the 31st employee. This requirement has been recently delayed by a year and will now go into effect in 2015.
If you do provide insurance, you could face a penalty of $3,000 per employee if the insurance is deemed “unaffordable” because it costs more than 9.5% of the employee’s income.
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Affordable Care Act - Individuals

What are my birth control benefits?

Asked Thursday, November 21, 2013 by an anonymous user

CPA Answer:

Plans in the Health Insurance Marketplace must cover contraceptive methods and counseling for all women, as prescribed by a health care provider.
These plans must cover the services without charging a copayment, coinsurance, or deductible when they are provided by an in-network provider.
All Food and Drug Administration-approved contraceptive methods prescribed by a woman’s doctor are covered.
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Affordable Care Act - Individuals

Do I qualify for Medicaid?

Asked Thursday, November 21, 2013 by an anonymous user

CPA Answer:

You qualify for Medicaid based on income and family size. If you're eligible, you get free or low-cost care and don't need to buy a Marketplace plan.
Medicaid provides health coverage for some low-income people, families and children, pregnant women, the elderly, and people with disabilities. Medicaid programs must follow federal guidelines, but they vary somewhat from state to state.
You may qualify for Medicaid - now or in 2017. The rules for Medicaid eligibility are different for each state. Most states offer coverage for adults with children below a certain income level, as well as pregnant women, some seniors, and people with disabilities.
Under the health care law, Medicaid eligibility is expanding in many states. More people than ever will qualify for Medicaid starting in 2017.Even if you were told you didn't qualify for Medicaid in the past, you may qualify under the new rules.
To see if you qualify for Medicaid, do one of these:Visit your state's Medicaid website. Use the menu at the bottom of this page to select your state and you'll be sent to the right page. You can apply right now and find out if you qualify.
But if you're not eligible now, you may qualify in 2017, when new rules take effect in many states. If you submit an application, the state will check the new rules when you apply.
Fill out an application for the Health Insurance Marketplace. When you finish this application, we'll tell you which programs you and your family qualify for. If it looks like anyone is eligible for Medicaid, we'll let the Medicaid agency know so your coverage can start in 2017.
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Affordable Care Act - Small Biz

Do employers have to notify their employees about the new insurance exchanges?

Asked Thursday, November 21, 2013 by an anonymous user

CPA Answer:

All companies with at least $500,000 in annual revenue and at least 1 employee must notify their employees about health coverage options, including the existence of the new insurance exchanges by October 1, 2013.
Employers are required to provide notice to each employee at the time of hiring beginning October 1, 2013. For 2014, the employer can provide notice within 14 days of the employee's starting date.
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Affordable Care Act - Individuals

Can child employees be covered under their parents plan?

Asked Thursday, November 21, 2013 by an anonymous user

CPA Answer:

Employees under the age of 26 may be eligible to be covered under their parent’s health plan
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Affordable Care Act - Individuals

Are the benefits the same in each state?

Asked Thursday, November 21, 2013 by an anonymous user

CPA Answer:

Generally, yes. But while all Marketplace plans offer the same general set of benefits, specific benefits may be different in each state. Even within the same state, there can be small differences between plans.
When you fill out your Marketplace application and compare plans, you'll see the specific benefits each plan offers.
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Affordable Care Act - Small Biz

Do all employers have to offer health care to their employees?

Asked Thursday, November 21, 2013 by an anonymous user

CPA Answer:

No. Only large employers will face penalties for not providing insurance to employees. Under the new ACA law, small businesses with less than 50 employees are exempt from the penalty for not offering coverage to their employees.
Small businesses that do offer insurance to its employees may qualify for a tax credit as an incentive.
For companies with at least 50 employees, there are penalties if the business does not offer health insurance.
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