Small Group (50 or Fewer Employees) Insured Plans and PPACA

PPACA brings numerous responsibilities and options to employers. Below is a summary of the PPACA provisions that apply to group health plans and whether the provision applies to insured small group plans provided inside and outside the SHOP exchange.

Note: For 2014 and 2015, the Patient Protection and Affordable Care Act (PPACA) considers a small group one that has up to 50 employees. (In most states, part-time employees count pro rata toward full-time equivalent employees using the same method as the play or pay requirement.) Beginning in 2016, for purposes of the insurance market requirements – but not the employer shared responsibility/play or pay requirement – a small group will be defined as up to 100 employees.