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5 commonly asked questions about employee benefits

Published on June 15th, 2017 by Triton Benefits & HR Solutions

When it comes to the various offerings companies provide for their employees, few are as important as healthcare benefits. Yet, workers commonly inquire about similar specifics related to their benefits options. In an effort to answer these queries and more, Triton Benefits and HR Solutions has compiled a list frequently asked questions and their appropriate responses that employers can use to their advantage.

1.What benefits are required by law?
Under the Affordable Care Act, there are certain health benefits that businesses must provide to their workers. Applicable large employers (ALEs) with 50 or more-full time equivalent employees must offer minimum essential coverage, which takes the shape of qualifying health plans such as those bought through the Health Insurance Marketplace, job-based options, Medicare Part A or Part C, coverage under a parent's plan and many others. Employers that don't provide these benefits – as well as individuals who forego insurance – can be subject to a monetary penalty under the shared responsibility provision.

2. Are full-time employees entitled to benefits?
Yes, ALEs with 50 or more full-time equivalent employees must provide health benefits to these workers. To be considered full-time, people must meet the following criteria, according to the IRS:

  • Works 30 hours of service per week, on average per month, or
  • At least 130 hours of service in a calendar month.

Full-time equivalent employees, on the other hand, are a combination of workers  – each of whom is not individually full-time – who are equivalent to full-time. Full-time and full-time equivalent individuals are entitled to the benefits explained above.

3. What are pre-existing conditions?
Pre-existing conditions are health issues employees were experiencing before signing up for – and the official start of – new coverage. Under the ACA, insurance companies cannot deny individuals or charge more for acceptance into a health plan because of these problems. The same rule – insurers cannot deny coverage to those with pre-existing conditions – also stands if workers change employers and experience no lapse in coverage, according to the Kaiser Family Foundation.

Some examples of these conditions include diabetes, asthma, cancer or high blood pressure, according to the U.S. Department for Health and Human Services.

"Employees should talk to their HR and benefits administrators for enrollment information."

4. When can employees sign up for benefits coverage?
Every company is different, but most enable employees to enroll in health coverage when they're first hired. For those who decide to forego that insurance – like individuals still on their parent's plan – there are often open enrollment periods throughout the year.

Workers should talk to their HR and benefits representatives to better understand sign-up periods as well as what items are included in employer-provided coverage.

5. Is healthcare taxable income?
In most cases, healthcare is not considered taxable income. Since employers pick up a percentage of the cost for these plans for their employees, the coverage is not subject to Social Security, Medicare, or federal unemployment taxes, or federal income withholding.

Do you have additional questions? Triton Benefits and HR Solutions can help.