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Health insurance tips for employers

Small vs. large employers

Health insurance laws apply differently to small and large employers. So, it is important to know the size of your employer.

  • Small employers with fewer than 50 employees do not have to cover employees or their dependents.
  • Large employers with at least 50 full-time equivalent employees may face a tax penalty if any full-time employee receives financial help to buy health insurance through an exchange such as HealthCare.gov. For more information please see the IRS’ guidance, which can be found here: https://www.irs.gov/affordable-care-act/employers/employer-shared-responsibility-provisions
  • Employers with fewer than 25 full-time equivalent employees may be eligible for tax credits to offset up to 50 percent of their premium costs.
  • Self-employed people with no employees can buy an individual health plan through healthcare.gov and may qualify for a subsidy to help with costs.

How do I know if I'm a small employer?

Under Oregon law, a small business is defined as having 50 or fewer employees. A full-time employee (FTE), under the Employer Responsibility section of the federal Affordable Care Act, works 30 hours or more per week.

These people do not count as employees:

  • Sole proprietors
  • Partners
  • The owner of the wholly owned corporation
  • A more than 2 percent shareholder of an S Corporation or limited liability company
  • The spouse of any person listed above

This calculator can help you determine if you have 50 or more FTE.

How are premiums set for employers?

In addition to the benefits selected, the amount a small employer (50 or fewer employees) pays for coverage depends on:

  • The average age of employees/dependents
  • The benefits the employer selects
  • Location in the state
  • The number of family members on the plan
  • Tobacco use by employees

Large employers negotiate rates directly with the insurance company; these plans' rates are not subject to state regulation.

Small business health care tax credit

The IRS Small Business Health Care Tax Credit helps qualified small businesses lower the cost of offering health insurance to employees. If you have a small business in Oregon, you must meet the following minimum criteria to qualify for the tax credit:

  • Employ fewer than 25 full-time equivalent employees (not including family members of owners/partners, or seasonal workers who work fewer than 120 days during the taxable year)
  • Pay average annual salaries of $50,000 or less per employee
  • Pay at least 50 percent of full-time employees' premium costs
  • Purchase a certified medical or dental plan

The maximum tax credit is 50 percent of the amount you pay toward your employees' premium costs (35 percent for tax-exempt employers). You don't need to offer coverage to your part-time employees or to dependents to qualify for the tax credit.

To learn more

Questions or complaints?

File a complaint online or contact us:

Insurance
888-877-4894 (toll-free)
Email cp.ins@oregon.gov

Financial services
866-814-9710 (toll-free)
Email dcbs.dfcsmail@oregon.gov

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