Read More

Affordable Care Act (ACA): Limits, Fees and Penalties Through 2021

↓ Want to download this? Click here to download the InfoBrief.↓

The Affordable Care Act (ACA) contains a number of limits and penalties that apply to employers.

Staying on top of the requirements can be a challenge. Our team of compliance experts has put together a guide of the important provisions employers need to stay on top of to ensure organizational compliance.

Employer Shared Responsibility (employer mandate) – requirement that applicable large employers (ALEs) offer affordable, minimum value coverage to substantially all full-time employees and their dependents

  • Affordability—an offer is affordable if the employee’s contribution, toward the employee-only rate, does not exceed a certain percent of their compensation. Employers use one of the three allowable safe harbor compensation methods to determine affordability, e.g. W-2, rate of pay, or federal poverty line (FPL).

Plan Years

2021

2020

2019

2018

2017

2016

2015

2014

Affordability Safe Harbor Percentages 9.83% 9.78% 9.86% 9.56% 9.69% 9.66% 9.56% 9.50%
  • Penalties—for failure to comply with the Employer Shared Responsibility provision
      • Tier 1 – Failure to offer to substantially all full-time employees
      • Tier 2 – Failure to provide coverage that is affordable or meets minimum value (plan reimburses at least 60% of the cost of essential health benefits)

     
    *Projected Amounts

    Employer Mandate Penalties—
    Calendar Year

    2021

    2020

    2019

    2018

    2017

    2016

    2015

    2014

    Tier one—
    Failure to offer coverage or to offer to 95% of employees (70% for 2015)
    $2,700 $2,570 $2,500 $2,320 $2,260 $2,160 $2,080 $2,000
    Tier two—
    Failure to offer coverage that is affordable and meets minimum value
    $4,060 $3,860 $3,750 $3,480 $3,390 $3,240 $3,120 $3,000

    Market Rules

        • Flexible Spending Accounts—the maximum amount of annual pretax dollars employees may put aside through payroll deduction to pay for qualified medical expenses
        • Health Savings Account (HSA)—an employee-owned bank account coupled with a qualified high deductible plan

    Listed below are the new limits, fees, and penalties for 2021, along with historical perspective.

    Account Limits

    2021

    2020

    2019

    2018

    2017

    2016

    2015

    2014

    Health Care Flexible Spending Account (FSA) $2,750 $2,750 $2,700 $2,650 $2,600 $2,550 $2,550 $2,500
    Dependent Care Flexible Spending Account (FSA) $5,000 $5,000 $5,000 $5,000 $5,000 $5,000 $5,000 $5,000

    Affordable Care Act (ACA)

    Annual Out-of-Pocket Maximums Self-only: $8,550
    Family: $17,100
    Self-only: $8,150
    Family: $16,300
    Self-only: $7,900
    Family: $15,800
    Self-only: $7,350
    Family: $14,700
    Self-only: $7,150
    Family: $14,300
    Self-only: $6,850
    Family: $13,700
    Self-only: $6,600
    Family: $13,200
    Self-only: $6,350
    Family: $12,700

    Health Spending Accounts (HSA)

    High Deductible Health Plan

    Annual Deductible Minimums Self-only: $1,400
    Family: $2,800
    Self-only: $1,400
    Family: $2,800
    Self-only: $1,350
    Family: $2,700
    Self-only: $1,350
    Family: $2,700
    Self-only: $1,300
    Family: $2,600
    Self-only: $1,300
    Family: $2,600
    Self-only: $1,300
    Family: $2,600
    Self-only: $1,250
    Family: $2,500
    Annual Out-of-Pocket Maximums Self-only: $7,000
    Family: $14,000
    Self-only: $6,900
    Family: $13,800
    Self-only: $6,750
    Family: $13,500
    Self-only: $6,650
    Family: $13,300
    Self-only: $6,550
    Family: $13,100
    Self-only: $6,550
    Family: $13,100
    Self-only: $6,450
    Family: $12,900
    Self-only: $6,350
    Family: $12,700

    Health Spending Account (HSA)—Maximum Contribution

    Maximum Contribution Self-only: $3,600
    Family: $7,200
    Self-only: $3,550
    Family: $7,100
    Self-only: $3,500
    Family: $7,000
    Self-only: $3,450
    Family: $6,850/$6,900
    Self-only: $3,400
    Family: $6,750
    Self-only: $3,350
    Family: $6,750
    Self-only: $3,350
    Family: $6,650
    Self-only: $3,330
    Family: $6,550

    Transportation Fringe Benefits

    Parking Mass transit n/a n/a $265/mo
    $265/mo
    $260/mo
    $260/mo
    $255/mo
    $255/mo
    $255/mo
    $255/mo
    $250/mo
    $250/mo
    $255/mo
    $130/mo

    Fees—Paid by Health Plan—per covered life

    2021

    2020

    2019

    2018

    2017

    2016

    2015

    2014

    Transitional Reinsurance Fee n/a n/a n/a n/a n/a $0 $27 $44
    Patient-Centered Outcomes Research (PCORI)
    Plan years ending 1/1 - 9/30 TBD TBD $2.54 $2.49 $2.39 $2.26 $2.17 $2.08
    Plan years ending 10/1 - 12/31 TBD TBD TBD $2.54 $2.45 $2.39 $2.26 $2.17

    Click here to download Affordable Care Act (ACA): Limits, Fees and Penalties through 2021

Share

Connect With a OneDigital Team Near You

Stay In The Know

Sign up for OneDigital's email newsletters!

Top