Reporting rules for the Affordable Care Act (aka Obamacare) were reviewed with the Council of Independent Business Owners on Nov. 6 at Chick-fil-A restaurant in North Asheville.

About 55 people attended.

On a separate matter, the CIBO received an update on the North Carolina Education Lottery  from its executive director, Alice Garland. 

A question-and-answer session followed each presentation.

The Obamacare address was made by Scott Hughes, CPA and vice president of assurance services for Johnson Price & Sprinkle; and Mary Williams, CPA and vice president of healthcare services for Johnson Price & Sprinkle.

Hughes began by noting that “this thing (Obamacare) was first approved in March 2012. It was intended to provide insurance for those who did not currently have it....  It created a level playing field ... ended pre-existing conditions.... It was gender-neutral.”

Whether or not one agrees that it achieved any or all of the aforementioned objectives,” Hughes noted that “11.4 million fewer uninsureds exist since before its implementation.... What we’re finding out, too, is a lot of those folks are sicker” than the average person enrolled with a health care policy before the advent of Obamacare.

“We’ll talk briefly about the individual mandate.... The individual mandate requires that individuals and members of their family have coverage — or you pay a penalty.

“There’s a premium tax credit, which reduces the amount of the premiums that was paid. If you weren’t qualified, you get to pay it back.

“If you’re $1 over the income threshhold, you have to pay it all back.

“It applies not only to those who are working, but to everyone in the family.

“If you got the subsidy, you received the form.... and from that, calculated whether you owe anything back.”

Next, Williams addressed the “large employer mandate,” which is applicable to large employers. Beginning Jan. 1, 2015, she said, applicable large employers who fail to offer minimum essential health care coverage at an affordable cost to substantially all of its full-time employees, or that employee risk having to pay a penalty.

Under the act, large employers are defined as those having more than 100 full-time equivalent employees (in 2015). That number goes down to 50 full-time equivalents in 2016 and thereafter — and “you must pay health care or pay penalty,” she noted.

“Who is a full-time employees?” Williams asked, rhetorically, and then answered herself. “It’s an average of at least 30 hours of service per week or 130-plus hours of service per month.

“Who is a full-time equivalent employee?” she asked, then providing the following list:

• Combination of part-time employees

• Aggregate hours of service of those not full-time

• Not more than 120 hours per employee

• Divide by 120

She said seasonal workers are “only applicable if (one has) plus-50 full-employees and FTE status exceeded for no more than....”

The “no coverage penalty” under the large employer mandate would involve failing to offer full-time employees (and their dependents after 2015), the opportunity to enroll in minimum essential coverage for any calendar month, and ....”if even one-full-time employee, $2,000; and 100 employees , so you’ll have a $200,000 penalty to the government. In 2015, you can exempt out the first 80 employees. So you pay just on 20 employees — $40,000.”

However, she added, “There is a little wiggle room.”

A second large employer mandate penalty involves the unaffordable coverage penalty, she said.

“They (full-time workers) cannot be expected to pay more than 9.56 percent of their household income for healthcare. (This penalty is $3,000 per employee)....This is a calculation that no business ever has had to make,” Williams noted.

“Now is the time to start getting the full-time equivalent info together. We’ve never had to do this before.”

During the Q&A that followed, CIBO member Mac Swicegood asked, “If I’m going to hire an employee, I need to call my accountant before I hire someone, right?”

“Well, there’s a lot of information required,” Hughes replied. “So if you’re over 50 full-time employees, this applies.”