your business is one that is affected by the Patient Protection and
Affordable Care Act, you’re probably concerned about the penalties
involved if you fail to meet one of the provisions. Here’s a list of
penalties and fines that you’ll want to be aware of.

Penalty Category: No Coverage Penalty for applicable large employer with 50 or more employees.

Effective Date: January 1, 2014

$2,000 per employee not counting first 30 employees if at least one
full-time employee has received premium assistance tax credit.

Penalty Category: Insufficient Coverage Penalty for plans not covering 60% minimum value

or costing employees more than 9.5% of W-2.

Effective Date: January 1, 2014

The lesser of $3,000 x the number of full-time employees receiving a
premium assistance tax credit OR $2,000 x the total number of full-time
employees (-30).

Penalty Category: Discrimination Testing Fines for not maintaining enough non–highly compensated employees on the employer health plan.

Effective Date: Expected January 1, 2014

Fine: $100 per person per day for all employees not “highly compensated.” This will most

be 75% of employees. (Fully insured grandfathered plans, does not
apply) For self-funded plans , benefits received under the plan become
taxable to the highly compensated employees.

Penalty Category: Failure to Issue MLR Rebates Properly

Effective Date: Already In effect, Fall 2012

Fine: $100 per entity, per day, per individual affected by the violation.

Penalty Category: Failure to Report Value of Health Coverage on W-2s

Effective Date: Already in effect, January 2012 (if 250+ W-2 forms prior year)

Fine: Varies. Most commonly $30 to $100 per W-2, depending on the length of time the employer fails to comply.

Penalty Category: Failure to Supply Contraception Benefits

Effective Date: Already in effect: 1st Renewal After August 2012

Fine: $100 per day per person to whom a failure to comply relates (unless grandfathered plan)

Penalty Category: Failure to Deliver Summaries of Benefit Coverage Each Renewal

Effective Date: Already in effect, 1st Renewal After Sept. 23, 2012

Fine: $1,000 for each failure to supply an SBC to an employee or beneficiary.

Penalty Category: Penalty on Individuals (not employers) Not Purchasing Insurance

Effective Date: January 1, 2014

Fine: Greater of $95 or 1% of pay in 2014; $325 or 2% of pay in 2015.

Penalty Category: Catchall Penalty for Coverage Related Violations

Effective Date: Already in effect, varies for some provisions

Civil enforcement suits under ERISA, as well as monetary penalties of
$100 per participant per day during period of noncompliance, up to an
annual max. of $500,000 or 10% of the group health plan’s expenses for
the prior year, whichever is less.