1. One of the biggest changes for 2016 is the definition of "small employer." Until Dec. 31, 2015, a small employer was typically defined as a business with between 1 and 50 full-time equivalent, or FTE, employees. For plan years beginning on or after Jan. 1, 2016, the definition of small employer will change to include businesses with between 1 and 100 FTE employees. This means employers with between 51 and 100 FTE employees will now have to meet ACA requirements for small group employers – unless the employer offers grandfathered plans – including offering plans that cover essential health benefits and meet ratings requirements.  NY is one of the states that insisted on keeping small group extended to 100 AFTER the Federal Gov't approved reversal back down to 50 lives.  In 2019 groups of 1-100 are still ruled under the guise of SMALL GROUP community rating.

2. There were more changes in 2016 for employers with 50 to 100 FTE employees. Though the group is considered a small employer for insuring purposes, it will be considered a large group employer for Employer Mandate penalty calculations. The mandate requires employers to offer minimum essential health coverage that is affordable and provides minimum value to 95 percent of its full-time employees and their dependents (up to age 26), or pay a penalty. In 2016, Employer Mandate penalties will apply to employers with between 50 and 99 full-time equivalent employees. That's a change from 2015, when the mandate only applied to employers with 100 or more full-time equivalent employees.  This is still true today in 2019.

3. Other changes to the Employer Mandate will also come into effect in 2016. In 2015, businesses with 100 or more FTE employees have to offer 70 percent of full-time workers health care coverage to avoid paying penalties. In 2016, businesses with at least 50 FTE employees must offer at least 95 percent of full-time employees insurance to avoid penalties. These businesses must also pay a penalty if a full-time worker receives a tax credit or cost subsidy through the ACA Marketplace because employer-provided insurance was unaffordable or didn't meet minimum value. In 2015, the first 80 full-time employees are excluded from counting toward the fee; in 2016, only the first 30 will be excluded.  This is still true today in 2019.

4. Beginning Nov. 15, 2015, businesses with 51 to 100 FTE employees can use the Small Business Health Options Program, or SHOP, online marketplace to purchase health care plans for employees. Prior to this date, the SHOP was only open to businesses with 50 or less FTE employees.

5. In 2019, the annual in-network, out-of-pocket maximum cost – including deductibles, copays and coinsurance – employers can require employees to pay before health coverage starts will go up to $7,900 for an individual and $15,800 for family coverage.

6. IRS penalties for failing to meet applicable large employer reporting requirements for 2018, which are due in 2019, or to provide individual statements to all full-time employees, will go up, as will penalty caps. For a full list of information reporting requirements and penalties, go to www.irs.gov/Affordable-Care-Act/Employers/Information-Reporting-by-Applicable-Large-Employers.