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Health Insurance Questions You May Have About the Employer Mandate

By Meredith Ledford on February 12th, 2010
Health Insurance

The employer mandate is a feature currently included in both the House and Senate versions of health care reform legislation. Here are answers to several questions you may have.

Q: What is the employer health insurance mandate?

A: Both the House and Senate versions of health care reform legislation contain an employer mandate, which requires employers to provide health insurance for their employees. In 2009, 60% of businesses offered health insurance to employees. Under the employer mandate, employers would be required to offer health insurance to all or a subset of their employees.

Q: How would an employer health insurance mandate be enforced?

A. The employer mandate would require companies to either "play or pay." This means that employers may choose to offer health insurance to their employees (the "play" option), or pay a fee or tax into a public fund that is used to cover uninsured workers (the "pay" option). Employer mandates are considered attractive by many because they build on the existing employer based health insurance system in the US.

Q: Would an employer health insurance mandate ensure coverage for me and my family?

A: Yes. The House and Senate bills differ, but they both require an employer to "play or pay."

The House Bill

Under the House bill, if your employer decides to "play," the company you work for would have to provide coverage to full-time employees (full-time employee has not yet been defined in this bill) and their dependents . In general, your employer would have to pay at least 72.5% of your health insurance premium and 65% of your de­pendent's premium. If your employer chose to "pay," 2%-8% of payroll would have to go towards a trust that provides coverage for the uninsured.

The Senate Bill

The Senate bill is more complicated. If you work 30 or more hours per week at a business with 50 or more employees, your employer must also "pay or play." Experts argue that this may not initiate change because most businesses that fall into this category already provide coverage to their employees and their dependants.

However, there may be some wiggle room for you to opt-out of your employer coverage and find coverage in the insurance exchange (or a new market place for insurance), in which case your employer would pay a fee. In the exchange, depending on the cost of the health insurance premium and your income, you would be eligible for a subsidy to help pay your health insurance premium.

It is still not clear what the outcome of health care reform may be. However, it is important to have affordable health insurance that meets the needs of you and your family -- be sure to get free health insurance quotes here so that you are prepared for the final version of health insurance reform legislation.

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