What is Pay or Play?

The Employer Mandate begins January 1, 2015 and you need to be prepared to decide whether you are going to follow the rules and regulations of providing affordable health insurance to your employees (Play) or pay the fines associated with not providing affordable health insurance (Pay). In order to make this decision, there are several things you need to take into account beforehand. It is important to note that the Employer Mandate only applies to “large employers.” If you are a “small employer” you are not required to provide health coverage to full-time employees.

In order to “Play” you must provide minimum essential coverage to your full-time employees that is affordable and fulfills the minimum value. If an employer fails to provide insurance for some or all of its employees, then they must “Pay” a penalty. There are different penalties associated with different scenarios for not providing insurance.

Providing insurance may be cheaper than paying the penalty, or paying the penalty may be cheaper than providing insurance. It all depends on your business and your employees.

What Do I Need to Know in Order to Decide?

Concepts you need to know

  • Large Employer Status

    Large Employer Status

    Being able to determine whether or not you are a large employer is important to know if you need to pay or play.

  • Look Back Periods

    Look Back Periods

    To know if you will be counted as a large employer you must understand look back periods and when to begin them.

  • FTE and FT Calculations

    FTE and FT Calculations

    Know how to calculate how many full-time employees, full time equivalents and part-time employees you have.

  • Minimum Value

    Minimum Value

    You need to know what exactly the minimum value of insurance is in order to comply with the ACA

  • Affordable Coverage

    Affordable Coverage

    It's important to understand what counts as affordable coverage and how to calculate the cost.

  • Penalties


    You will need to estimate the potential penalties associated with not providing affordable health insurance.

How can we help?

Obamacare: A Handbook for Employers will give you all the knowledge and tools you need in order to make your decision process smooth and easy. Our handbook provides a step by step guide on navigating your business through the ACA. You will get vital information on what you need to prepare for whether you are a large employer, small employer or an individual.

We will provide special packages for you that will include checklists and worksheets, real world examples, presentations to share with your employees, and a glossary of important terms. We also have other websites dedicated to expanding your knowledge on Obamacare. Want to find out when Obamacare starts? Then click here!



Real-World Scenarios

We want to make sure you understand Obamacare down to the very bone. In addition to getting a fresh look at the Obamacare legislation through the eyes of an employer, you will have a chance to work through some real-world scenarios. Find out how large and small companies will need to adapt to comply with Obamacare. These examples include all current calculations needed to decide which course of action to take. Employers can use these examples and worksheets to get a better understanding of the steps they need to take in the face of the new health care law.

Take Bob for example. He is a small independent franchise owner who has two locations. Each location employs 7 full-time managers and 36 part-time employees that work an average of 60 hours a month. To determine if he is a large employers, does Bob need to calculate each location separately, or altogether? What are the calculations he needs to make to determine if he is in fact a large employer? If he is not a large employer, what are his options? Can he receive a tax credit? If so, how much?

We will walk you through, step by step, different business scenarios so you can compare it to your own situation. From a small surf shop that has continuous seasonal workers, to a large company with over 50 locations, there is a scenario for everybody.