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Life Health > Health Insurance > Health Insurance

Broker: PPACA Penalty Unfair

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A health insurance producer says she has found a quirk in the Patient Protection and Affordable Care Association (PPACA) employer responsibility provision that seems to be particularly upsetting.

Gail Hiller-Lee of Bernard A. Hiller Inc., Uniondale, N.Y., notes that employers over a certain size will have to provide health coverage for employees or else face the risk of having to pay a penalty for each employee who applies for health coverage using a new system of PPACA tax credits through a new PPACA health insurance exchange system.

PPACA is supposed to prod employers to offer more attractive health benefits and hold workers’ share of premiums down by requiring them to pay the penalty if the workers’ share of the premiums costs more than 9.5% of the workers’ income and the workers apply to buy coverage through the exchange – even if those employers already offer health benefits.

Hiller-Lee says her understanding is that, when the workers at an employer with group coverage apply for exchange plan coverage, the employer will have to pay the penalty “even if [the price] is the same or more expensive the the private group plan.”

“My problem with that is that the government will not give that same employee a subsidy to pay for his portion of the contribution that exceeds the 9.5% – only if they purchase it through the exchange,” Hiller-Lee says. “It seems a great disadvantage to the private carrier and to the group, who may not have the participation to keep a private plan in force..”

- Allison Bell

Other PPACA consequences coverage from National Underwriter Life & Health:


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