Tax Credit Employees Payroll

The Small Business Jobs Act of 2015 (the “Act”) provides for a new business tax credit intended to make it easier for small business to keep and attract employees. As the Act was passed, it’s safe to say that the legislative process was complicated by the massive amount of publicity that the ACA (Affordable Care Act) had received. The complex process resulted in changes to the provisions of the tax code, tax cuts, a delayed implementation date, and an extended deadline for the IRS to issue guidance in its implementation of the Act. Regardless, the new credit will apply to all small businesses and is not limited to those that provide health insurance. The results for small business owners (e.g. sole proprietorships, partnerships, and LLCs) can be quite complex, but below are some of the details for a summary of the new credit and its application for 2018.

Details of The New Tax Credit

The new tax credit, the Small Business Health Options Premium Contribution Credit, is available for businesses that purchase health insurance for their employees through a special exchange set up by the IRS. Any small business that qualifies for the credit must buy health insurance through a health exchange. The exchange must be established by the IRS and be “nationally operated and administered” (which in the case of the exchanges used by the State of Washington is www.connectforhealthofored.org).

One requirement of the new credit is that the exchange must be set up under Section 1311 of the ACA, which allows the federal government to issue grants to states to set up their own exchanges. The eligibility of small businesses to receive the tax credit depends on the amount of the employee premium contribution. The amount of the credit is determined by calculating the sum of the premium paid by the employee and the subsidy paid by the employer in the form of an HAS contribution.

The maximum tax credit is $3,400 for 2018, but because the amount of the subsidy is included in the calculation, the maximum is reduced to $1,400 if the employer doesn’t make a contribution. Businesses must also meet one other criterion for tax credit eligibility, which is that a company’s average full-time employee size must not be more than 25.

Additionally, any small business that is subject to the minimum wage, has less than 50 full-time employees, and has 50 or more employees must comply with requirements for health insurance coverage, must also participate in a qualified small business health exchange for 2018. The exchange must be developed by the IRS as an alternative to the State of Washington’s exchange, which is http://vsbwa.org/index.cfm.

Ways for Small Business Premium Credit

There are two ways in which the small business health option premium credit will apply to a small business: either at the time of purchase or at the end of the first year. The credit is claimed as a credit on a business’s federal income tax bill; however, the IRS is not yet issuing guidance on how the credit should be calculated. The IRS will issue guidance later in 2018, but until then, businesses should consult with their accountants and tax advisors.

In 2018, the credit for the first year is limited to $3,450. For 2019 and thereafter, the small business health options premium credit is available to the full amount of the 2018 premium. The credit will apply to the full cost of an individual employee’s health insurance premiums. To be eligible, the health insurance plan has to cover more than 6 million health care services and must cover an employee’s care in the form of health plan benefits that are subject to the small business health options premium credit.

The 2018 tax credit will be subject to several limitations:

For the 2018 tax year, the credit will not be available if the business already qualified for the 2017 credit, or if the business had more than 50 employees on the last day of the year. (The Act does not provide for grandfathering of tax credits.)

Small businesses that plan to purchase health insurance for the 2019 and beyond will need to know more about when and how to apply for the tax credit. The IRS has not released a detailed plan for when and how to apply for the 2022 small business health options premium credit, but tax advisors and accountants will need to read the IRS guidance later this year. It is not yet known when or how the IRS will make this guidance available to tax advisors and accountants, but we will provide updates as soon as they are available.

Additional Requirements for the Tax Credit

There are several additional requirements for the tax credit for employers to qualify. A minimum of 50 full-time employees must be employed by the company, and there must be at least one full-time employee with the option to enroll in the exchange.

Another requirement is that the businesses must be in the federal income tax reporting cycle for the period of their tax year, including the calendar year. For businesses, the calendar year begins on the first day of the month that contains the first Friday of the month. The year that a business falls in must begin on a new tax year and must end on the same tax year.

Here’s the most complicated part of the new tax credit for small businesses. You must have a separate plan set up by the exchange and a participation rate at least equal to the federal exchange participation rate. In addition, the plan must be offered through a licensed and qualified insurance provider.

Finally, the insurance plan must have at least 10 employees enrolled in the plan. These requirements are a double whammy for small businesses because they have to buy a separate plan to qualify for the tax credit. This is similar to the situation that the millions of people who receive subsidies in the exchanges must face.

What To Expect

The new tax credit for small business owners to purchase health insurance through the exchange is a controversial topic, and many small business owners, business owners, and business organizations are concerned that this credit will make their employees more expensive to cover. In fact, you can read some of the frustration and even anger that the tax credit has generated. One advocacy group has already spoken out against the new tax credit and has warned that it is “punishing small businesses for the failure of the individual health insurance market.”

Still, for those small business owners who need the tax credit to purchase health insurance on the exchange, it’s worth keeping in mind that they will only be able to claim this credit for one year, 2017. In 2018, they must make sure they enroll employees into qualified health plans in a new tax year in order to qualify for this tax credit. ERC reports that fewer than half of small businesses with fewer than 50 employees currently meet the requirements to qualify for the tax credit.

There are still other concerns about the tax credit. ERC reports that small businesses that are in the 25% federal income tax bracket would see the cost of their employees covered by their business plans increase by thousands of dollars in 2018. The group reports that small business owners are concerned about the additional cost of buying health insurance on the exchange. Additionally, small business owners are concerned that their employees are going to take advantage of the tax credit by staying covered on their employer’s plan. This would result in costs going up for small business owners, who are already facing the added cost of the tax credit itself.

Since the federal tax credit is one year only, it is also important for small business owners to get the most benefit they can out of this tax credit to ensure they get the most bang for their buck. According to ERC, the tax credit is too expensive for many small business owners. The federal tax credit will cost owners $3,000 per employee in 2018. In total, that’s an increase of $10,000 per employee in 2018. ERC also reports that there will be fewer small business owners who qualify for this tax credit, which will likely lead to more complaints.

While the tax credit will certainly save many small business owners money, it still comes at a significant cost. Since it costs $3,000 per employee to buy coverage for a family in 2018, small businesses that offer family coverage are going to face significant increases in their costs. If these businesses only have three employees and only have access to the federal exchange, they are going to face a huge tax increase. But for business owners who are already feeling financial pressure, this increase will be particularly painful.

Although the tax credit is designed to benefit small businesses and their employees, it is also only one piece of the Affordable Care Act. While it is helping a segment of small businesses, it is having a negative impact on those without the ability to purchase health insurance on the exchange.

However, it is possible to make up for the impact by opting to purchase the health care you need on the individual exchange. On the individual market, there is less administrative overhead and more flexibility, and there is no tax credit at all. If you feel that you can afford it, you should at least make sure you have access to health insurance by purchasing on the exchange.

So where should you get health insurance if you cannot find a plan that meets your needs on the exchange? In some states, there are other options. If you are going to purchase on the individual market, you should consider the following considerations:

Find a plan that you actually want

Health insurance isn’t a “have to” in most cases, and you shouldn’t be forced into it. The cost and benefits of a plan are determined by you. In general, it’s a good idea to shop around and get more information about different plans before choosing one.

Look for better benefits

Many people prefer lower premiums to better benefits, but both are important. You want to ensure you are getting adequate coverage and that it is what you want. You might be surprised by what you find. Do your research and learn about what the benefits of the plan you are looking at will include.

Work with a certified public accountant

Certified public accountants (CPAs) have an important role in understanding the tax advantages of a particular plan. As professionals, they can also help you identify and manage your health insurance needs. They can help you understand what’s deductible and what’s not, which can help you keep your costs down. If you are selling a policy to employees, a CPA can help you with your disclosures and liabilities to the IRS. CPA’s can also evaluate the plan to make sure you understand everything about your coverage.

Evaluate the difference between a “preferred provider organization” (PPO) and a “substandard provider organization” (SPO)

A PPO is a more cost-effective alternative to an HMO or an HAS. You can often get a PPO plan for $0 premium and more if you use your preferred provider. However, there are restrictions on which doctors and facilities are accepted and the network of facilities can be more limited.

A SPO works a lot like a HMO. You can use whichever doctors and facilities you like, but some networks have more in-network facilities than others. This can be a little more restrictive than the PPO option and can put a limit on what you can get for your health insurance premium.

If you choose a PPO, be sure to compare any out-of-pocket costs with the cost of a PPO with a high-deductible plan. In some cases, you might be paying less than you would for a standard-deductible plan with higher out-of-pocket costs.

Adjust the deductible

Even though a standard-deductible plan means that you don’t have to pay anything out of pocket for the first $1,300 of out-of-pocket expenses, you will still have to pay a higher deductible. This can be a good thing if you use your insurance a lot or if you have a medical condition. If you have a family, it can be a little more challenging, but the difference is well worth the lower premiums.

Avoid high-deductible plans

If you can’t control the deductible and don’t need all of the benefits of a PPO, you might want to go with a high-deductible plan instead. Your total out-of-pocket expenses will usually be higher, but you’ll be better protected if anything unexpected comes up. If you do have an unexpected expense, you will still have coverage, but it will be at a much higher deductible than you would have had otherwise.

Talk to a family or group practice physician or see if your health insurance plan provides coverage for visits to a primary care physician. You may be able to save money by choosing a PPO, but an out-of-network provider could be more expensive. As you can see, there are many ways to manage your health insurance costs. Take the time to learn about them all and do your research. You won’t regret it.

How to Apply For 2022 Small Business Health Options Premium Credit

In order to take advantage of the 2022 tax credit, a small business must take steps to purchase health insurance for the 2022 tax year. The first step is to contact the health exchange where your business is located. If your business is subject to the minimum wage requirements of the State of Washington, you must also find out if you have to comply with minimum wage requirements for 2018.

If your business is not subject to the minimum wage requirements of the State of Washington, you do not need to consult with the State of Washington for minimum wage compliance; you can take the small business health option premium credit as soon as you pay your 2022 health insurance premiums and are subject to the small business health option premium credit.

If your business is subject to the minimum wage requirements of the State of Washington, consult with the State of Washington to determine what minimum wage requirement your business must comply with in 2022. The minimum wage requirement could be similar to the 2022 minimum wage requirements for 2018, and may also apply to minimum wage wages for other years, but your business will need to check with the State of Washington to find out.

A small business that has paid health insurance premiums for 2018 must then pay the premium for 2022 health insurance coverage to the health insurance exchange where they have purchased 2018 coverage. If your small business does not buy 2018 coverage through an exchange, you must wait until 2018 coverage renewals are available. At this time, the small business health option premium credit will be available to your small business for the 2018 health insurance premiums paid for 2019.

Small Businesses Required to Provide ‘Non-VA Care’ Coverage for 2019

Some small business owners who purchased individual insurance coverage this year may be required to provide “non-VA care” coverage beginning January 1, 2019. Non-VA care coverage is a type of health insurance coverage required by federal law that is not available through the small business health option premium credit. If you have 2018 health insurance coverage through an exchange or are enrolled in the Small Business Health Options program, you may be required to provide non-VA care coverage for 2019.

You will have to identify a third party health insurance carrier for 2019 and provide proof that the carrier has a minimum number of employee participants to be treated as a qualified “non-VA provider” under the law, or provide a certification that you are a qualified “non-VA provider”. If you are subject to this requirement, you will need to take this step as soon as 2019 coverage renewals are available.

Actual costs of Non-VA Care and Benefits

The amount that the small business health option premium credit will actually increase a small business’s health insurance premiums in 2019 will be impacted by many factors, such as the cost of actual “non-VA care” offerings. However, a third party provider of non-VA care will typically charge a premium that is similar to that of a VHA provider for “non-VA care”, except that the third party non-VA care provider has not been rated as a “Top Tier provider” by the Centers for Medicare & Medicaid Services, and so a small business may be required to pay more for “non-VA care” than VHA providers. Additionally, the cost of a non-VA care “package” to an employee is typically higher than the cost of an individual physician visit, as VHA hospitals typically have a larger network of providers.

Payment of Non-VA Care Premiums for 2019

If a small business is required to provide non-VA care for 2019, the small business health option premium credit will be “clawed back” from that small business’s premium payment to the health insurance exchange and be used to pay the third party carrier for the “non-VA care” premium. The amount of this clawback will be dependent on the amount of “non-VA care” coverage that the small business has, and the small business owner’s actual “non-VA care” payments for 2019.

If a small business pays the third party carrier for both the “non-VA care” premium and the “fee for service” premium, the cost of both of those premiums is paid by the small business health option premium credit. If the small business health option premium credit payment for the “non-VA care” premium is greater than the third party carrier’s fee for “non-VA care” premium, then the small business health option premium credit payment will be used to pay for the “non-VA care” premium. The small business health option premium credit will not be used to pay the fee for “fee for service” premium.

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