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Although Obamacare has received mixed reviews, it’s clear that it has a significant impact on small business owners and their employees.
The Patient Protection and Affordable Care Act (ACA), referred to as the Affordable Care Act or “ACA” for short, was signed into law by President Barack Obama in March of 2010 and aims to extend insurance coverage to uninsured Americans and to slow the increasing costs of healthcare.
“Obamacare,” as it’s most often referred to, is the most controversial and far-reaching healthcare legislation in decades. The law was designed to increase access to affordable health insurance, but it also has a number of provisions that affect small businesses. As a business owner, you need to be aware of how Obamacare will impact your company.
The ACA authorized the creation of new healthcare marketplaces, also known as exchanges, where individuals and small businesses can purchase health insurance. Businesses with 50 or more full-time or full-time equivalent (FTE) employees are required to offer affordable health insurance.
Businesses with 1-49 full-time employees are not subject to this requirement. However, due to the expensive nature of individual healthcare products from the marketplace, small businesses need solutions to help employees.
The Affordable Care Act mandates that all businesses with 50 or more full-time or full-time equivalent (FTE) employees must provide health insurance for their employees. If a company fails to do so, they are subject to penalties. Despite this requirement, many believe the ACA does not help small business owners. Some of these individuals have argued that because of the mandate, small business owners are now paying higher premiums for less coverage, and as a result, are forced to cut back on hiring and other benefits to cover the costs.
In addition, under Obamacare, many Americans are required to purchase private health insurance if they are not covered by an employer or other government-assisted health plans such as Medicaid, Medicare, or TRICARE. The Individual Mandate applies to residents of California, Massachusetts, New Jersey, Rhode Island, Vermont, and the District of Columbia.
Employer responsibilities under the Affordable Care Act include offering affordable, comprehensive health coverage to at least 95% of their full-time employees. Health coverage is considered “affordable” if the employee contribution for premiums is no more than 9.12% of household income in 2023 for employee-only coverage. It is “comprehensive” if it provides a minimum value of at least 60% of the total allowed cost of benefits provided by a typical employer plan and includes substantial coverage of physician and inpatient hospital services.
There are three key federal requirements for ACA Eligibility. These requirements apply in all 50 U.S. States. They are:
When an employee enrolls for a healthcare plan through the marketplace, they may be eligible to receive an advanced premium tax credit to help offset the cost of their monthly healthcare premiums. Certain household income limits must be met to qualify for the premium tax credit. Household income must be at least 100 percent and, for years other than 2021 and 2022, no more than 400 percent of the federal poverty line for family size.
Open Enrollment is the period each year when individuals are allowed to enroll in or make changes to a marketplace health insurance plan. The yearly open enrollment period runs from November 1 – January 15. Outside open enrollment, an individual may still be able to enroll in marketplace coverage if they have certain life events, like getting married, having a baby, losing other health coverage, or based on their estimated household income.
One of the most important aspects of the ACA for small business owners is the insurance market standards that it sets. Before the ACA, insurance companies were able to discriminate against people with pre-existing conditions and charge women higher rates than men. The ACA outlaws these practices and requires insurers to provide coverage to everyone, regardless of their health status or gender. This has made it easier for small business owners to get health insurance for themselves and their employees.
The Affordable Care Act set out to standardize small-group and individual health insurance plans by creating a colored “metal” ranking for each of three tiers or levels, with each level based on actuarial value. The colors of the tiers are bronze, silver, and gold.
All new small group and individual health insurance plans, including plans sold in the exchange as well as plans sold in the private market, must fall into one of the metal levels (unless it’s a catastrophic plan in the individual market).
The law requires that all plans offer a minimum level of coverage starting with the bronze tier, which covers 60 percent of an individual's medical costs. Silver and gold-tiered plans are also available, which cover 70 and 80 percent of medical costs, respectively.
Benefits under a bronze plan can be complex but essentially provide a basic amount of protection at a relatively low cost. A silver or gold plan might work better for those who have more robust coverage needs, such as for families or those with significant out-of-pocket expenses due to chronic conditions. Catastrophic plans are also available, which provide high levels of coverage in case of injury or illness but not for routine, preventive care.
Besides ACA products, other health coverage options include health savings accounts (HSA). HSAs may be a good choice for business owners and individuals because they can contribute to them on a pre-tax basis and withdraw funds from them on a tax-free basis if used for qualified medical expenses. HSAs require consumers to take responsibility for monitoring their own health care costs and providers and may be particularly beneficial for those who are self-employed.
High-Deductible Health Plans (HDHPs), Health Sharing Ministry Plans, Primary Care Memberships, and Private, Non-Marketplace Plans are all health coverage alternatives outside of the ACA. There are many options for small business owners and individuals to choose from based on personal needs and budget.
In addition, the ACA offers small business healthcare tax credits to small businesses that purchase health insurance for their employees through its Small Business Health Options Program (SHOP).
If a business with 50 or more full-time employees fails to meet the ACA’s minimum requirements for providing health insurance to its staff, penalties may be levied.
If an employer with 50 or more FTE employees doesn’t offer coverage to at least 95% of FTE employees, the potential penalty is $2,900 per full-time employee in 2025 (that amount started at $2,000 but has been adjusted for inflation). The first 30 employees are excluded from the calculation. For example, if an employer has 65 FTE employees, doesn’t offer any health coverage, and at least one employee gets coverage in the exchange and qualifies for a premium subsidy, the employer would owe a $101,500 penalty for 2025. The calculation is: (65-30) x 2,900 = 101,500.
On the other hand, if an employer provides a health plan, but that plan is unaffordable and/or doesn’t provide minimum value, the employer would face the lesser of two penalty options: $4,350 per employee receiving premium subsidies in the exchange (this started at $3,000 but has been indexed for inflation), or the $2,900 per full-time employee (minus the first 30) penalty as described above.
To illustrate, consider a business that has 120 full-time employees and offers coverage, but it’s either not affordable and/or doesn’t provide minimum value: If 70 employees get subsidies in the exchange in 2025, the employer would pay a penalty of $259,200 for the year ((120-30) x 2,900 = 261,000). That’s the lesser of the two penalties, with the alternative penalty calculation totaling $304,500 (70 x 4,350).
How to Navigate
As small business owners, we never expect to be faced with the number of challenges that can arise when starting a business. We want the domain and freedom to build something great. Administrating and navigating healthcare has made that unnecessarily difficult.
The reality is that the Affordable Care Act is now law and most likely here to stay. You can get a broker to help you implement and manage health care for your workers or you can do it on your own.
Your Health Insurance Alternative
The continued rising cost of healthcare has made it difficult for small (and medium-sized) businesses to operate, including providing healthcare. Many employers are now opting for lower-cost minimum essential care plans as a way to not only reduce their expenses but help employees do the same.
Meridio offers a solution to the growing problem of rising healthcare costs by providing small businesses with affordable, ACA-compliant, basic health coverage plans for themselves and/or their employees. Anyone can take advantage of our guaranteed acceptance plans with licensed Benefits Guides and a Customer Care team available to assist with enrollment and offer continued support. We remove the administrative burden so that companies can offer quality healthcare without inconvenience or a lengthy process to implement.
We’re happy to answer all your questions and help you decide what’s right for you. For moreinformation you can request information here.
New York, NY. June 6th, 2025 - Meridio, a leading provider of healthcare as a managed service for small businesses, today announced the appointment of Larry Dunivan as their newest Board Member. Dunivan brings over four decades of executive leadership experience in technology and human capital management to support Meridio's continued growth and innovation in the healthcare services sector serving small businesses.
"We are thrilled to welcome Larry Dunivan to our Board of Directors," said Bobby Sain, Chief Executive Officer at Meridio. "His extensive experience as an operator, and developing companies in the Human Capital Management space, as well as his strategic vision will be a great asset as we continue to grow in the coming years.”
Dunivan most recently serves as Founder at Cefalo Group and serves on the Board of Directors at Pay Federate, an AI-driven solution for compensation. With a focus on intuitive design and seamless integration, Payfederate simplifies the complexities of compensation, ensuring transparency and fairness
In addition to this, he holds a position on the Board at Asurint, a background screening company that uses technology and innovation to deliver fast and accurate results. Honing in on team development and business expansion across the software industry.
"I'm honored to join Meridio's Board at such a pivotal time in healthcare delivery transformation," said Dunivan. "Small businesses face unique challenges in providing quality healthcare benefits to their employees, and Meridio's innovative approach is addressing this critical need. I look forward to contributing to the company's mission of making comprehensive healthcare accessible and affordable."
WIth a passion for developing strong leadership and interpersonal development, Dunivan brings invaluable insight to Meridio’s future growth. He holds a Bachelor of Arts degree from Northwestern University, where he went on to continue his studies in Accounting and Information Technology earning his Masters of Business Administration.
Dunivan's appointment comes as Meridio continues to expand its healthcare management services designed specifically for small businesses seeking enterprise-level healthcare solutions without the associated complexity and cost. Learn more about Meridio at www.getmeridio.com
For more information please contact Jen Taylor, Director of Marketing at 929-412-1921 or email jtaylor@getmeridio.com
While it might sound like just another trendy term, it’s a serious issue that can impact your team’s well-being and productivity.
Burnout is a state of emotional, physical, and mental exhaustion caused by prolonged stress. It can sneak up on anyone, especially in unstable environments with toxic work culture. According to Forbes, 80% of Americans say they feel stressed at work. If you’ve noticed your employees losing their spark, they might be experiencing burnout. Recognizing burnout early is key to keeping your team on track. Here are some common signs:
Low Energy Levels
An increased drop in enthusiasm or detachment from work and colleagues. If a team member who is usually full of energy is suddenly dragging through the day, that could be a red flag.
Productivity Slumps
Missing deadlines, reduced quality of work, or lack of focus are all classic signs that a team member may be struggling with burnout.
Physical Symptoms
Headaches, stomach issues, or frequent illnesses can be more obvious signs of underlying stress. WellRight also notes that symptoms like panic attacks, chest pains, an increased heart rate and changes in appetite, leading to weight loss or gain can also be a common sign of employee burnout.
Social Withdrawal
When an employee starts withdrawing from social interactions or avoiding meetings and team activities, it’s time to check in.
Concerned about your team’s well-being? Learn how Meridio’s health insurance plans offer comprehensive mental health coverage.
A research conducted by Monster in April 2024 found that 78% of workers don’t think their employer is doing enough to address their mental wellness at work. The key to preventing burnout is balance, with an overall goal of creating an environment where your team can thrive. Here’s how:
Encourage Breaks: It’s not just about the lunch hour. Regular breaks throughout the day are necessary to maintain focus and energy.
Promote Flexibility: Offering flexible work hours or locations can help employees manage stress.
Recognize Achievements: Acknowledge and reward your team’s hard work. A little appreciation goes a long way in boosting morale.
Maintain Open Communication: Make sure your team knows they can talk about their workload and mental health without fear of repercussions.
Provide Mental Health Resources: Ensure your team knows about any mental health support your company provides, from counseling services to stress management workshops.
Leverage Health Insurance Coverage: Highlight the mental health services covered by your company’s health insurance plan. Comprehensive coverage that includes therapy, counseling, and other mental health resources can be a crucial support system for your employees.
Looking to support your team’s mental health? Explore our Guide to Preventing Employee Burnout
While Mental Health Month is a great reminder, mental health shouldn’t be a once-a-year conversation. Recognizing the signs of burnout and taking proactive steps can keep your team motivated and productive year-round.
At Meridio, we offer healthcare plans that prioritize mental health coverage. Our Value Medical plans include access to therapy and psychiatry anytime, anywhere through Recuro Health. Contact us today to find out how to get started with Meridio.
As a thriving business with a growing workforce, the complexities of health insurance and employee benefits shouldn't be your full-time headache. We understand that knowing the wellbeing of your workforce lies in your hands can feel daunting, but we're here to help.
The renewal period for these benefits is a crucial time to reassess, evaluate, and make decisions about your coverage offering that will not only impact your bottom line but also the long-term wellbeing of your team.
Here is a comprehensive checklist to guide you through the renewal process smoothly and effectively:
Before jumping into new plans or options, take a moment to assess your current benefits package:
Are your employees satisfied with their health coverage? Consider conducting anonymous surveys to gather feedback on what they value most about their existing plans.
Examine aspects such as the network of providers, out-of-pocket costs, and additional benefits like dental or vision coverage. Understanding your team's needs is essential for making informed decisions during your renewal.
Ask your broker or health benefits carrier to provide a claims history from the past year. Analyze the types of services your employees are utilizing most and assess the costs associated with those claims. This will help you identify trends and potential areas for improvement in finding affordable health coverage.
A thorough review of the services used by your team can empower your decisions and help you negotiate better terms with your insurance carriers. This also allows the opportunity to add supplemental coverages and wellness programs if needed, based on the claims history for your team.
Determine what you can realistically afford in terms of renewal costs. Account for premium increases, but set a clear budget and cap on your spend. If you elect for employee contribution, be sure you understand what that covers and how it affects your employees.
Consider how changes in premiums will affect your overall financial expenses. While providing valuable benefits is important, balancing costs with business sustainability ensures long-term success.
Once you have your budget, start comparing different plans and see how they stack up against what you're currently offering. Look beyond just the premium costs; evaluate the coverage, network access, co-pays, deductibles, and out-of-network options.
Partnering with a knowledgeable managed service provider like Meridio can save you time and ensure you explore all possibilities without the headache and complexity of navigating the market. They can help you find the best health benefits for your company.
Incorporating wellness programs can effectively enhance employee participation in your benefits program while reducing long-term healthcare costs. Consider options that promote physical and mental well-being, such as fitness reimbursements, stress management workshops, or telehealth services.
These initiatives not only attract new talent but help retain current employees by fostering a supportive work environment where employee wellness is a priority. Research shows that when considering a new position, prospective employees often choose affordable health benefits over better pay.
Health benefits are heavily regulated, with changes in the market occurring yearly. Ensuring that your plans comply with the latest Affordable Care Act (ACA) regulations will help you avoid hefty penalties. Another way to ensure your business is compliant is by partnering with a managed service provider such as Meridio. They simplify the benefits process and take care of everything from administration and set-up to enrollment and ongoing service.
Staying informed about changes in healthcare laws protects your business from potential penalties and legal issues. Consider consulting with a compliance expert to navigate complex areas if you don’t have a reliable broker or health partner.
Before the renewal process begins, effectively communicate with your employees about all expected plan changes and create a space for everyone to ask questions and review the new options. Hold an informal meeting and send out digital updates with enrollment reminders to ensure everyone is on the same page.
Giving your employees time to discuss health coverage options with their household and family allows everyone a fair chance to waive or elect benefit coverage. Provide materials that outline the new benefits, highlighting any modifications, costs, and important deadlines. This transparency fosters trust and helps your employees feel valued.
Health benefits should not be a once-a-year consideration. Make it a habit to periodically review your offerings throughout the year. Economic conditions, employee demographics, and market trends can shift, so staying adaptive is crucial. Speak with experts who can walk you through a cost comparison and answer questions to help guide your healthcare decisions. At Meridio, their experts help you understand your current costs versus average marketplace options to see where you could save or spend differently.
Regular check-ins with your existing health benefits carrier or broker can help you make more timely adjustments. Keep them on a first-name basis and rely on them to be your guide in the benefits space, being transparent with your business needs and expectations will go a long way.
After you've completed your health benefits renewal, solicit feedback from your employees about the new plans and the enrollment process. Understanding how these changes affect your team's daily lives and productivity is critical for future decisions.
Use this insight to improve the benefits package during the next renewal cycle. Keeping an open line of communication with your team as the year progresses will allow you to have a clear picture of the wellness culture within your organization.
Renewing employer-paid health benefits is a significant opportunity to enhance your team's welfare and safeguard your business's financial bottom line. By following this checklist and staying empathetic to your employees' needs, you can create a low-cost benefits package that not only meets compliance requirements but also builds a strong, loyal workforce.
Your team's well-being is an investment that pays dividends for your organization's success! Download our free 'Benefits Renewal Red Flags' checklist below to be sure you're on top of the best health insurance options for your team.
