What Are Employer Responsibilities Under the Affordable Care Act? 

If you’re an employer in Melville, NY, staying on top of your Affordable Care Act (ACA) obligations is a year-round job. Knowing your responsibilities helps you avoid penalties and keep your workforce covered.

Who Is Subject to ACA Requirements?

The ACA’s employer mandate applies to Applicable Large Employers, generally businesses with 50 or more full-time equivalent employees. They must offer affordable, minimum-value coverage to at least 95% of full-time employees and their dependents, or risk IRS assessments.

Key Compliance Responsibilities

Employers subject to the ACA typically must:

• Offer coverage to full-time employees (those averaging 30 or more hours per week) and their dependents.
• Ensure coverage meets minimum value and affordability standards; for 2026, affordability is 9.96% of household income for self-only coverage.
• File Forms 1094-C and 1095-C for annual 6056 reporting, and 6055 reporting if you sponsor a self-insured plan.
• Distribute accurate employee statements.

Other federal laws carry their own notices and deadlines:

• COBRA: With 20 or more employees, offer continued group health coverage after qualifying events.
• FMLA: With 50 or more employees, provide unpaid leave while maintaining group health coverage.
• HIPAA: Follow the rules on how your group health plan uses and shares health information.
• Medicare Part D: Notify Medicare-eligible individuals whether your drug coverage is creditable.
• Section 125: Maintain compliant cafeteria plan documents and testing.

New York Requirements

New York adds its own rules. Employers with fewer than 20 employees may offer state continuation coverage, and insured plans must allow up to 36 months. Nearly all employers must carry Disability and Paid Family Leave coverage once they have employees on at least 30 days in a calendar year. Employers with five or more employees must also provide paid sick leave of up to 40 hours a year, or 56 hours with 100 or more employees.

Compliance Services That Support Your Team

MAX Total Benefits Solutions, Inc. provides compliance services, including:

• ACA and DOL compliance
• 6055/6056 reporting
• 1094/1095 filing
• HR assistance
• Employee benefits statements
• Employee handbook

Contact MAX Total Benefits Solutions, Inc. to learn how our compliance services can help your organization meet its obligations.

 

 

This blog is intended for informational and educational use only. It is not exhaustive and should not be construed as legal advice. Please contact your insurance professional for further information.