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| ICHRA | Group Health Insurance | |
|---|---|---|
| Reimbursement model | Employers choose contribution amounts based on employee class and family size. | Employers offer a plan, or a selection of plans to employees - and if the employer chooses - their employees' families. |
| Is minimum participation required? | No | Yes |
| Employer contribution limits | No minimums or maximums | No. However, in order to be eligible for the Small Business Health Care Tax Credit, employers must contribute 50% or more of the cost of premiums for all full-time employees. |
| Employer eligibility | Employers of any size with at least one other employer (other than their spouse). | Generally, small employers with 1-50 employees are eligible for SHOP. Employers of any size can offer group coverage. |
| Employee eligibility | Any employee classes of the employers' choosing, including part-time and seasonal workers, so long as they have minimum essential coverage. | Any employee classes of the employers' choosing |
| Coverage flexibility | Employees choose their health insurance plan and what healthcare purchases they make so long as they are qualifying expenses. If they choose to leave the company, they can keep their current plan. | Employees have a plan or selection of plans to choose from that offer minimum essential coverage based on what the employer chooses to offer. |
| Enrollment | Employers can enroll any time of the year. Employees with an ICHRA election will be offered a special enrollment period. | Small businesses can generally enroll during any time of the year. |
| Tax information | ICHRA reimbursements are not taxed to the employee. However, if an employee accepts an ICHRA offer they cannot receive premium tax credits. | Group health plan contributions are generally not taxed to the employee. However, in order to offer a SHOP plan the employer must be eligible for the Small Business Health Care Tax Credit - which means they must contribute 50% or more of full time employees' premiums. |
| ICHRA |
|---|
Reimbursement modelEmployers choose contribution amounts based on employee class and family size. |
Is minimum participation required?No |
Employer contribution limitsNo minimums or maximums |
Employer eligibilityEmployers of any size with at least one other employer (other than their spouse). |
Employee eligibilityAny employee classes of the employers' choosing, including part-time and seasonal workers, so long as they have minimum essential coverage. |
Coverage flexibilityEmployees choose their health insurance plan and what healthcare purchases they make so long as they are qualifying expenses. If they choose to leave the company, they can keep their current plan. |
EnrollmentEmployers can enroll any time of the year. Employees with an ICHRA election will be offered a special enrollment period. |
Tax informationICHRA reimbursements are not taxed to the employee. However, if an employee accepts an ICHRA offer they cannot receive premium tax credits. |
| Group Health Insurance |
Reimbursement modelEmployers offer a plan, or a selection of plans to employees - and if the employer chooses - their employees' families. |
Is minimum participation required?Yes |
Employer contribution limitsNo. However, in order to be eligible for the Small Business Health Care Tax Credit, employers must contribute 50% or more of the cost of premiums for all full-time employees. |
Employer eligibilityGenerally, small employers with 1-50 employees are eligible for SHOP. Employers of any size can offer group coverage. |
Employee eligibilityAny employee classes of the employers' choosing |
Coverage flexibilityEmployees have a plan or selection of plans to choose from that offer minimum essential coverage based on what the employer chooses to offer. |
EnrollmentSmall businesses can generally enroll during any time of the year. |
Tax informationGroup health plan contributions are generally not taxed to the employee. However, in order to offer a SHOP plan the employer must be eligible for the Small Business Health Care Tax Credit - which means they must contribute 50% or more of full time employees' premiums. |
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If you are a small business owner with 25 full-time employees or less, and pay an average salary less than or equal to $50,000 a year, you might be eligible for a tax credit.* This tax credit was created under the Patient Protection and Affordable Care Act (PPACA) in order to give small businesses and tax-exempt organizations a break on the cost of group health insurance for their employees.
The federal tax credit will reimburse qualifying small businesses for up to 50% of the premiums they pay towards employee medical, vision and dental insurance. Tax-exempt organizations may qualify for a tax credit of up to 35% of premium expenses.
*In some states, the tax credit only applies to Qualifying Health Plans (QHPs) bought through government exchanges. Other restrictions may apply.
Small businesses with fewer than 10 full-time employees that pay average annual wages of $25,000 or less may qualify for the full credit. The amount of the credit is reduced for companies with more full-time workers and higher wages, until it is phased out entirely for those with 25 or more full-time workers and average annual wages over $50,000.
Because eligibility rules are based in part on the number of full-time employees, not the total number of all employees, businesses that use part-time help may qualify even if they employ more than 25 individuals.
This article is for general information and is not tax, accounting, or legal advice. Please consult a tax, accounting, or legal advisor for advice on your specific situation.
We offer a broad selection of Pennsylvania Employer Health Insurance plans from many of the leading Pennsylvania health insurance companies.
Business owners in Pennsylvania can expand their health insurance offerings to include group dental insurance and group vision insurance. Pennsylvania small business owners can also refer to the following resources about owning and operating a small business in Pennsylvania:
You can browse plans and read articles online or call and get personalized recommendations from one of our agents. No charge, no expectations to enroll.
Whether you are looking for the perfect group dental, group vision, small business health insurance, or group health insurance plan in Pennsylvania, eHealth has you covered.
