Skip to content

The Employer Shared Responsibility Provision

The Payment

There are two types of payments. The first applies if you do not offer at least 95 percent of your full-time employees (and their dependents) coverage - this is the payment under 4980H(a).

The second applies if you do offer your employees the opportunity to enroll in coverage, but the coverage is not affordable or does not provide minimum value - this is the payment under 4980H(b).

For both payments, you will be liable if at least one of your employees receives the premium tax credit.

No Offer of Coverage

You may be liable for this payment if you don't offer the opportunity to enroll in eligible employer-sponsored plan for a calendar month to at least 95 percent of your full-time employees (and their dependents) and at least one of your full-time employee receives the premium tax credit (you will receive a Section 1411 Certification for each employee that receives the premium tax credit).

The payment amount is computed monthly. It is 1/12th of $2,000 multiplied by a certain number of your full-time employees. Your employees included in determining the payment are all your full-time employees except for employees in a limited non assessment period and reduced by 30.

Coverage not Affordable or did not Provide Minimum Value

You may be liable for this payment if you do offer your full-time employees (and their dependents) the opportunity to enroll in minimum essential coverage under an eligible employer-sponsored plan, but at least one of your full-time employees received the Premium Tax Credit (you received a Section 1411 Certification for that employee).

Generally, a full-time employee will receive the premium tax credit because the minimum essential coverage offered was not affordable, did not provide minimum value, or because the employee was not one of the at least 95 percent of full-time employees offered minimum essential coverage.

The payment amount is computed monthly. It is 1/12th of $3,000 multiplied by the number of your full-time employees for whom you received the Section 1411 Certification, excluding those employees that are in a limited non-assessment period and were offered the opportunity to enroll in minimum essential coverage that provided minimum value and met one or more of the affordability safe harbors. This payment will also not be greater than the first type of payment (no offer of coverage).

Affordability Safe Harbors

The affordability safe harbor rules apply only to the second type of payment (the payment under 4980H(b)). Use of any of the safe harbors is optional, and you may choose to apply the safe harbors for any reasonable categories of employees, provided you do so on a uniform and consistent basis for all employees in a category.

There are three affordability safe harbors: the Form W-2 safe harbor, the rate of pay safe harbor, and the Federal poverty line safe harbor. More information on the safe harbors and how they apply is available from the IRS questions and answers on the employer shared responsibility provisions and in the ESRP regulations.

More Information

More information on both payments are in the ESRP Regulation sections for the payment under 4980H(a) and payment under 4980H(b) and from the IRS Types of employer payments and how they are calculated page.

Applicable Large Employer Status

An employer with 50 or more full-time employees or equivalents is called an "applicable large employer" (ALE) and is subject to the provision. ALE status is determined by counting the number of your full-time employees and full-time equivalents for the prior calendar year and dividing the total by 12. If the result is 50 or more, you are an ALE for the current calendar year.

Full-Time Employees

In general, your full-time employees are, with respect to a calendar month, those employed an average of at least 30 hours of service per week. Alternatively, 130 hours of service in a calendar month is treated as the monthly equivalent of at least 30 hours of service per week.

Full-Time Equivalent Employees (FTEs)

In determining whether you are an applicable large employer, the number of FTEs employed during the preceding calendar year is taken into account. All employees (including seasonal workers) who were not employed on average at least 30 hours of service per week for a calendar month in the preceding calendar year are included in calculating the FTEs for that calendar month.

Calculating the number of FTEs: The number of FTEs for each calendar month in the preceding calendar year is determined by calculating the aggregate number of hours of service for that calendar month for employees who were not full-time employees (but not more than 120 hours of service for any employee) and dividing that number by 120.

In determining the number of FTEs for each calendar month, fractions are taken into account; an employer may round the number of FTEs for each calendar month to the nearest on hundredth.

Counting Employees' Hours of Service

Count each hour for which an employee is paid, or entitiled to payment, for the performance of duties; and each hour for which an employee is paid, or entitled to payment for a period of time during which no duties are performed due to vacation, holiday, illness, incapacity (including disability), layoff, jury duty, military duty or leave of absence.

Certain hours are excluded when counting employees' hours of service:

  • Bona fide volunteers: Hours of service do not include any hour for services performed as a bona fide volunteer.
  • Work-study program: Hours of service do not include any hour of services to the extent those services are performed as part of a Federal Work-Study Program or a substantially similar program of a State or political subdivision thereof.
  • Services outside the United States: Hours of service do not include any hour for services to the extent the compensation for those services constitutes income from sources without the United States.

Hourly and non-hourly calculation

Hourly employees calculation: For employees paid on an hourly basis, calculate actual hours of service from records of hours worked and hours for which payment is made or due.

Non-hourly employees calculation: Except as otherwise provided, for employees paid on a non-hourly basis, an employer must caluclate hours of service by using one of three methods: actual hours worked, days worked equivalency, and weeks worked equivalency. Information on how each method applies in calculating hours of service are in the ESRP regulations.

Prohibited use of equivalencies: The days-worked or weeks-worked equivalency method cannot be used if the result of using either will:

  • Substantially understate an employee's hours of service such that an otherwise full-time employee is not treated as such
  • Understate the hours of service of a substantial number of employees, regardless of whether the understatement does not understate any particular employee and does not cause an otherwise full-time employee to be treated as not full-time.

Seasonal Workers

Even if you have 50 or more full-time employees during the prior calendar year, you may not be considered an applicable large employer if the employees in excess of 50 are seasonal workers.

If the sum of your full-time employees and full-time equivalents exceeds 50 for 120 days or less during the preceding calendar year, and the employees in excess of 50 who were employed during that period of no more than 120 days are seasonal workers, then you are not considered to employ more than 50 full-time employees (including FTEs) and you are not an applicable large employer for the current calendar year.

For this rule, four calendar months may be treated as the equivalent of 120 days, and the four calendar months and the 120 days are not required to be consecutive.

First Year as a Large Employer

An employer not in existance throughout the preceding calendar year is an applicable large employer for the current calendar year if the employer is reasonably expected to employ an average of at least 50 full-time employees (taking into account FTEs) on business days during the current calendar year and it actually employs an average of at least 50 full-time employees (taking into account FTEs) on business days during the calendar year.

An employer is treated as not having been in existence throughout the prior calendar year only if the employer was not in existence on any business day in the prior calendar year.

The seasonal worker exception also applies to employers not in existence the preceding calendar year.

Determining Full-Time Status of Employees

There are two methods that you can use to determine the full-time status of your employees: the monthly measurement method and the lookback measurement method.

Employee Categories

You may use either the monthly measurement method or the look-back measurement method for different categories of employees and are not required to use the same method for all categories.

The permissible employee categories are:

  • Collectively bargained employees and non-collectively bargained employees,
  • Each group of collectively bargained employees covered by a separate collective bargaining agreement,
  • Salaried employees and hourly employees, and
  • Employees whose primary places of employment are in different States

Switching Between Methods

If you use different measurement methods for different categories of employees and an employee has a change of status that switches the employee from one method to the other, special rules apply.

Information on using the look-back and monthly measurement methods for different categories of employees and applying changes in employment status resulting in a change in full-time employee determination method is in the ESRP Regulations.

Monthly Measurement Method

Under the monthly measurement method, you determine if an employee is a full-time employee on a month-by-month basis by counting the employee's hours of service for the month.

An employee with an average of at least 30 hours of service per week is a full-time employee. Alternatively, 130 hours of service for the month is equivalent to 30 hours of service per week.

Weekly Rule

The weekly method allows you to measure your employees' hours of service based on periods of 4 or 5 weeks that overlap with either the first or last day of the calendar months.

  • For months with 4 weeks, if the employee has at least 120 hours of service the employee is a full-time employee.
  • For months with 5 weeks, if the employee has at least 150 hours of service the employee is a full-time employee.

Under this rule, the period you use to measure your employees' hours of service must either:

  • Begin on the first day of the week that includes the first day of the calendar month and the last week does not include the last day (unless that week ends with the last day of the calendar month, in which case it is included), or
  • Begin on the first day of the week after the first day of the calendar month and the last week includes the last day of the month (unless the week begins on the first day of the calendar month, in which case it is included).

Ongoing Employees

An ongoing employee is an employee who has been continuously employed by you without any breaks in service.

New Employees

A new employee is an employee who has not been previously employed by you.

Employees Resuming Services after an Absence

An employee resuming services is an employee with a prior period of employment (such as a rehire or after a period of leave) and, according to the rehire and continuing employee rules, may be treated as either a new or ongoing employee.

Information on the rehire and continuing rules as they apply to the monthly measurement method, as well as international transfers, can be found in the ESRP Regulations.

Lookback Measurement Method

Under the look-back measurement method, you determine the status of an employee as a full-time employee during what is referred to as the stability period, based upon the hours of service of the employee in the preceding period, which is referred to as the measurement period.

Measurement Periods

The lookback measurement method works by using a period, the measurement period, where you count the hours of service for your employees.

The standard measurement period is used for ongoing employees (or an employee resuming services that is treated as ongoing) and the initial measurement period is used for a new employee (or an employee resuming services that is treated as a new employee).

Standard Measurement: The standard measurement period is 3 – 12 months and can begin on any day of any month. If an employee has an average of at least 30 hours of service per week during this period, that employee is treated as a full-time employee during the stability period that follows.

Initial Measurement: The initial measurement period is also 3 – 12 months. It can begin on either the new employee's start date (or the date an employee resumes services, if that employee is treated as a new employee), any day after the start date up to and including the first day of the first calendar month after the start date, or (if you are using the payroll period method) the first day of the first payroll period following the start date (even if later than the first of the following month).

Optional Administrative Periods

This is an optional period that is no longer than 90 days. It begins immediately following the end of a measurement period and ends immediately before the start of the associated stability period.

For the initial measurement period, it also includes the period between a new employee's start date and the beginning of the initial measurement period, if the initial measurement period does not begin on the employee's start date.

Stability Periods

If an employee has an average of at least 30 hours of service during the measurement period, the employee is a full-time employee through the whole stability period associated with that measurement period.

Employee Categories

Subject to certain rules governing the length of the measurement and stability periods, you may use measurement periods and stability periods that differ either in length or in their starting and ending dates for categories of employees:

  • Collectively bargained employees and non-collectively bargained employees,
  • Each group of collectively bargained employees covered by a separate collective bargaining agreement,
  • Salaried employees and hourly employees, and
  • Employees whose primary places of employment are in different States.

Payroll Period Rule

For payroll periods that are one week, two weeks, or semi-monthly in duration, an employer is permitted use payroll periods as a measurement period so long as either the first payroll period or the last payroll period overlaps with the first day or last day of the measurement period – but not both.

More information about how the payroll period rull applies can be found in the ESRP Regulations.

Ongoing Employees

An ongoing employee is an employee who has been employed for at least one complete standard measurement period.

New Employees

Under the look-back measurement method, a new employee is an employee who has been employed for less than one complete standard measurement period.

Variable hour, part-time and seasonal employees

Generally, a variable hour employee is an employee that, based on the facts and circumstances at the employee’s start date, you cannot determine whether the employee is reasonably expected to be employed on average at least 30 hours of service per week during the initial measurement period because the employee’s hours are variable or otherwise uncertain.

The hours of your new variable hour, part-time and seasonal employees are measured using an initial measurement period until they have been employed for at least one full standard measurement period.

Transition from New to Ongoing Employee: Once a new variable hour employee, new seasonal employee, or new part-time employee has been employed for an entire standart measurement period, you test the employee for full-time employee status, beginning with that standard measurement period, at the same time and under the same conditions as apply to ongoing employees.

Other new employees

The status of your employees who are not variable hour, not part-time, and not seasonal that you reasonably expect to be full-time employees is determined based on the employee's hours of service for each calendar month.

Once the new employees are employed for at least one full standard measurement period, their hours are measured as your other ongoing employees.

Factors determining full-time status: Whether your determination that a new employee (who is not a seasonal employee) is a full-time employee or is not a full-time employee is reasonable is based on the facts and circumstances at the employee's start date. Information on the factors determining full-time status can be found in the ESRP Regulations.

Employees Resuming Services after an Absence

An employee resuming services is one that is rehired after termination of employment or who is resuming service after another absence. Employees resuming services may be treated as a new employee or ongoing employee depending on how long the employee was employed with you before the absence and how long the employee was gone.

Information on the rehire and continuing employee rules, including rules on International Transfers, can be found in the ESRP Regulations.

Treatment as new employee: If the employee is treated as a new employee, determine the full-time status as you would for any other new employee.

Treatment as Ongoing Employee: If the employee is treated as an ongoing (or continuing) employee, determine the full-time status as you would for your other ongoing employees.

Anti abuse rule: In the case of the rehire and continuing employee rules, any hour of service is disregarded if the hour of service (or services giving rise to the crediting are requested or required of the employee) for a purpose of avoiding or undermining the employee rehire rules.

KEY TERMS

Administrative period

An optional period you select that is no longer than 90 days that begins immediately after the end of a measurement period and ends immediately before the start of the associated stability period.

The administrative period also includes the period between a new employee's start date and the beginning of the initial measurement period, if the initial measurement period does not begin on the employee's start date.

Affordable coverage

Generally, coverage is affordable for an employee if the employee's required contribution of the annual premium for self-only coverage does not exceed an applicable percentage of the employee's household income for the year. Depending on the employee's household income, the applicable percentage is between 2 and 9.5 percent.

Applicable large employer

With respect to a calendar year, an employer that employed an average of at least 50 full-time employees (including full-time equivalent employees) on business days during the preceding calendar year.

Employee resuming services

An employee that has previously been employed by you, but experienced a break in service (for example, due to termination and rehire or unpaid leave). Depending on the rehire and continuing employee rules, these employees can be treated as a new employee or as an ongoing employee.

Full-Time employee

Generally, with respect to a calendar month, an employee who is employed an average of at least 30 hours of service per week.

Hours of service

The hours for which an employee is paid, or entitiled to payment, for the performance of duties for the employer; and each hour for which an employee is paid, or entitled to payment by the employer for a period of time during which no duties are performed due to vacation, holiday, illness, incapacity (including disability), layoff, jury duty, military duty or leave of absence.

Certain hours are excluded from hours of service; for more information, see the ESRP Regulations.

Hours of service monthly equivalency

As part of counting hours of service for your employees: 130 hours of service in a calendar month is treated as the monthly equivalent of at least 30 hours of service per week, and this 130 hours of service equivalency applies for both the look-back measurement method and the monthly measurement method for determining full-time employee status.

Initial measurement period

Under the lookback measurement method: A period of at least three but not more than 12 consecutive months that is used to determine the full-time status of your new employees. A new employee that averages at least 30 hours of service per week during the initial measurement period is treated as a full-time employee through the end of the associated stability period that follows.

Limited non-assessment periods

The limited non-assessment period for certain employees refers to the limited period during which an employer will not be subject to an assessable payment under section 4980H(a) and in certain cases 4980H(b), with respect to an employee as set in the ESRP Regulations:

Minimum Value

An eligible employer-sponsored plan provides minimum value only if the plan’s share of the total allowed costs of benefits provided to the employee under the plan (as determined under guidance issued by the Secretary of Health and Human Services) is at least 60 percent.

New employee

Under the look-back measurement method, a new employee is an employee who has been employed for less than one complete standard measurement period.

Under the monthly measurement method, a new employee means an employee who has not previously been employed.

Ongoing employee

Under the lookback measurement method, an ongoing employee is an employee who has been employed for at least one complete standard measurement period.

Under the monthly measurement method, an employee who has been continuously employed by you without any breaks in service.

Section 4980H(a) applicable payment amount

With respect to any calendar month 1/12 of $2,000, adjusted for inflation.

This amount is multiplied by a certain number of your full-time employees for a calendar month to calculate the actual payment.

Section 4980H(b) applicable payment amount

With respect to any calendar month, 1/12 of $3,000 – adjusted for inflation.

This amount is multiplied by a certain number of your full-time employees for a calendar month to calculate the actual payment

Stability period

Under the lookback measurement method: A period you select that immediately follows and is associated with a standard measurement period or an initial measurement period (and if elected, the administrative period associated with that standard measurement period or initial measurement period).

Standard measurement period

Under the lookback measurement method: A period of at least three but not more than 12 consecutive months that is used to determine the full-time status of your employees. Employees that average at least 30 hours of service per week during the standard measurement period are treated as full-time employees through the end of the associated stability period that follows.

Variable hour employee

Generally, an employee that, based on the facts and circumstances at the employee’s start date, you are unable to determine whether the employee is reasonably expected to be employed on average at least 30 hours of service per week during the initial measurement period because the employee’s hours are variable or otherwise uncertain.

Waiting Period

A waiting period is the period that must pass before coverage for an individual who is otherwise eligible to enroll under the terms of a group health plan can become effective. If an individual enrolls as a late enrollee or special enrollee, any period before such late or special enrollment is not a waiting period.