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===Regulations and Provisions that affect small businesses with fewer than 50 employees===
Although small businesses with less fewer than 50 employees do not have to run the risk of paying the employer mandate for not providing health care insurance to its employees, there are some regulations and provisions associated with the ACA that increase the cost of providing and receiving health care (for those that do choose to do so). Employers are required to provide their employees with a Summary of Benefits and Coverage Disclosure Rules (SBC’s), a standard form that essentially explains to employees what their plan entails (noncompliance may result in a further penalty). The Additionally, the ACA also institutes a cap on the maximum contribution an employee can make toward a flexible spending arrangement ($2500), increases Medicare withholding withholdings on employees with wages over $200,000 and $250,000 for married joint filers, and assesses net investment income for Medicare (taxable capital gains, dividends, rents, royalties, and interests) for single filers with a Modified Adjusted Gross Income of $200,000 for a single filer (and $250,000 for married joint filers). The ACA also institutes a 90-day maximum waiting period for employees to provide health care coverage employees who are eligible and creates incentives for incentivizes employers to put in place offer Workplace Wellness Programs. For employers that sponsor self-insured plans, there is an additional information reporting required that is separate from information reporting required for employers with more than 50 FTE [https://www.sba.gov/content/employers-with-up-to-50-employees].===Options for small businesses with fewer than 50 employees that still provide health care===
Although, health care is not a mandatory service for small businesses with fewer than 50 FTE many small businesses still provide health insurance for their employees. These companies, along with large companies, are seeing rising premiums on their insurance due to the ACA stipulation that health care companies cannot deny coverage when considering an individual's health. However, there are options to compensate with the increased (while also non-mandatory) cost of providing health care, the most obvious of which would entail the end of employee-sponsored health insurance coverage by small businesses or simply increasing the employee contribution to coverage.
Small businesses can try to save on rising health care costs in various ways, such as participating in the SHOP Exchange, negotiating on private insurance plans, converting their employee group plans into individual employer-sponsored plans, such as Health Savings Accounts or Health Reimbursement Accounts (HSA’s and HRA’s), switching to direct primary care, or using Workplace Wellness Programs [http://www.cnbc.com/2015/01/08/5-smart-ways-small-firms-can-slash-health-care-costs.html].
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