Affordable Care Act

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How health care reform affects your business

Health care reform is in full swing now, with most major provisions in place. Under the Affordable Care Act (ACA), health care reform presents you with the opportunity to re-examine your health care strategy and keep your organization ahead of the curve.

To make the right decisions, you’ll need to answer such key questions as:
  • How does the ACA impact my decision of whether to offer coverage?
  • Is my business considered large or small under the ACA?
  • What employer requirements do I need to be concerned with?
The following pages provide a high-level overview of primary ACA provisions, things to consider, and next steps to take.

Select your business size to learn more

Small and Large Business Definitions by State

California and Colorado

Small Business is 1-100 employees. (This was previously 1-50.)

Large Business is 101+ employees.

District of Columbia, Georgia, Hawaii, Maryland, Oregon, Virginia and Washington

Small Business is 1-50 employees.

Large Business is 51+ employees.

  • *The tax references in this website are provided for informational purposes only and relate to federal income tax only. Consult with your financial or tax advisor for more information about federal income tax and state income tax laws.
  • Many health plan issuers consider businesses with 51 or more full-time-equivalent employees (FTEs) a large business. However, for some provisions of the ACA, large businesses are defined as groups having 50 or more FTEs. FTEs include both full-time and part-time employees. With regard to the employer shared responsibility provision, full-time employees are those who work a monthly average of at least 30 hours a week or 130 hours a month. In 2016, some states expanded the definition of small business to include employers with up to 100 employees. In these states, businesses with up to 100 employees will have access to the Small Business Health Options Program (SHOP).
  • Although we have attempted to present accurate information, Kaiser Permanente disclaims any express or implied warranty as to the accuracy of any material contained herein, any liability with respect to it, and any responsibility to update this material for subsequent developments. As required by the IRS, we inform you that any tax advice contained in this website was not intended or written to be used or referred to, and cannot be used or referred to, (i) for the purpose of avoiding penalties under the Internal Revenue Code, or (ii) in promoting, marketing, or recommending to another party any transaction or matter addressed herein. Users should consult with their own attorney or tax professional before making tax-related decisions.