Health Reform: Q&A With Dealerships

The following are answers to questions we heard during our health reform presentation for dealerships, sponsored by MADA.

Q: Does an employer include employees that are 65 years old or older for purposes of determining how many full-time employees and full-time equivalents they have?

A: Yes, all employees are considered in the full-time equivalent calculation.

Q: For W-2 reporting purposes, what is included for health insurance benefits?

A: The full premium (employee + employer share) is reported on the W-2.

Q: If an employer has multiple companies with separate EINs but the company is a part of a controlled group, is the 250 W-2 threshold based on an individual underlying company or at the controlled group level?

A: The small employer exemption applies to this. Small employers are those employers that were required to file fewer than 250 Forms W-2 in the preceding calendar year. The 250 Form threshold is not measured across the employer’s controlled group. For example, if a parent corporation separately filed 200 Forms W-2 for 2011 and has two subsidiary corporations that each separately filed 200 Forms W-2 for 2011, all three corporations could qualify for the small employer exemption for 2012. Notice 2012-9 clarifies that the determination of whether an employer is required to file fewer than 250 Forms W-2 in a calendar year is determined based on the Forms W-2 that the employer would have been required to file without regard to the employer’s use of an agent under Internal Revenue Code section 3504. At a minimum, this small employer exemption is applicable for 2012 Forms W-2; it will apply for later years unless further guidance is issued.

Q: For employees that are paid on a commission basis, how is their compensation determined for federal poverty level purposes?

A: W-2 income is used to determine affordability for the subsidy and the exchange will likely look at household income, which would also include commissions.

Q: Please confirm the $2,000 no coverage or inadequate coverage penalty is based only to full-time employees, not full-time equivalents.

A: Correct.


Scott Gorden, Managing Partner, Dealerships
scott.gorden@cliftonlarsonallen.com or 612-376-4751

Doug Bertossi, Partner, Benefits Services
douglas.bertossi@cliftonlarsonallen.com or 612-376-4693

Mrudul Sharma, Manager, Dealerships
mrudul.sharma@cliftonlarsonallen.com or 612-376-4513