ACA Health Insurance is shorthand for Affordable Care Act-compliant Health Insurance, which refers to an individual or group health insurance policy that meets the stringent coverage requirements of the Affordable Care Act (ACA).
According to the U.S. Department of Health and Human Services, the three goals of the ACA when enacted in March 2010 were:
- to make affordable health insurance available to more Americans (this is done through premium tax credits that reduce the cost for low-income households);
- to expand the federal Medicare program to cover all adults with incomes below 138% of the Federal Poverty Level (FPL), and,
- to support innovative medical care delivery methods designed to reduce the cost of health care, generally.
Originally, the ACA had two mandates: one for individuals to have ACA-compliant health coverage (or pay a fine); and another for employers that requires Applicable Large Employers (ALEs) to offer minimum essential coverage that is “affordable” and that provides minimum value to full-time employees (and their dependents). ALEs also have to report annually on their offer (or failure to offer) minimum essential coverage.
The ACA individual mandate was essentially repealed when the penalty for not having ACA-compliant coverage was reduced to zero at the end of 2018.
Most employers fall below the 50-employee threshold and are not subject to the employer mandate (also known as the shared responsibility provision).
According to the Internal Revenue Service, to be an ALE an employer must have at least 50 full-time employees, including full-time equivalent employees, on average during the prior year.
To determine its workforce size for a year, an employer adds its total number of full-time employees for each month of the prior calendar year to the total number of full-time equivalent employees for each calendar month of the prior calendar year and divides that total number by 12. A full-time employee calculator is available on the HealthCare.gov website.
Individual and Family Plan (IFP), ACA-compliant insurance is available in a variety of ways: directly with an online source such as the Health Insurance Marketplace, with assistance from a broker, or directly through an insurance company. Similarly, employers looking for group insurance can contact a carrier directly, work through a broker or benefits consultant, or purchase coverage through the Health Insurance Marketplace.
See listings for Health Insurance Marketplace and Private Health Insurance Exchange for additional information.