Health insurance offers invaluable coverage that helps individuals get the medical care they need at affordable rates. Not only does health insurance provide such important coverage, but since the passing of the Affordable Care Act (ACA), individuals in South Carolina and the United States are required to carry an active health insurance policy.
Here’s everything you need to know about South Carolina’s health insurance requirements, including whether or not employers are required to provide health insurance for their employees.
Is Health Insurance Required?
The Affordable Care Act requires South Carolina residents to have health insurance. Previously, the residents who did not have health insurance were subject to a federal tax penalty for foregoing health insurance. However, this tax penalty has been done away with. So, while health insurance is still required under the ACA, there is not currently a penalty for those that do not have active coverage.
Minimum Essential Coverage
The ACA requires residents to have a health insurance policy that meets the guidelines for Minimum Essential Coverage. Plans that meet these guidelines include:
- Plans purchased through Healthcare.gov
- Individual insurance plans that you have had since before March 23, 2010
- Employer-provided policies, including COBRA
- Plans bought outside of Healthcare.gov that meet the guidelines for qualified health insurance policies
- Most Medicaid policies
- Medicare Part A and Part C
- Children’s Health Insurance Program policies
- Student health plans
- Coverage under a parent’s health insurance policy
- And more
If you’re not sure whether or not your health plan qualifies, speak with an experienced KSA Insurance agent.
Are Employers Required to Provide Health Insurance?
While most employers do offer health insurance to their employees, South Carolina does not currently have any laws that require them to do so. The ACA does impose a penalty on certain companies with 50 or more full-time employees that do not provide health insurance to at least 95% of their full-time employees. This is known as the Employer Shared Responsibility Payment.
However, this does not apply to small employers—those with fewer than 50 full-time or full-time equivalent employees. Though, if a business does offer group health insurance to some employees, it must provide coverage to all of its similarly situated employees. For example, if a business decides to provide health coverage for certain full-time employees, it must provide coverage access to all full-time employees.
Employers are also required to provide healthcare coverage if it is promised in an employment contract. For example, if an employee is part of a union whose collective bargaining agreement guarantees health coverage, then the employer must provide it.
Lastly, employers cannot provide employee benefits in a discriminatory manner. This includes discriminating on the basis of race, gender, nationality, disability, age, religion, color, pregnancy, or genetic information. For example, it would be illegal for an employer to only provide healthcare coverage to employees under a certain age.
Group Health Insurance for Employers
While employers in South Carolina are not required by state law to provide health insurance, doing so helps your employees receive the care they need and protects them from extreme financial damages due to the high costs of uninsured medical care. By providing this invaluable coverage, businesses can encourage employee loyalty, boost morale, and attract more high-level talent.
Businesses may also qualify for tax credits if they offer group health insurance plans to their employees. Your business may qualify for a tax credit equal to as much as 50% of your healthcare premium contributions if your business:
- Has fewer than 25 full-time or full-time equivalent employees making $50,000 or less per year; and
- Pays for at least half your employees’ premiums
How Group Health Insurance Works
With a group health insurance plan, employers share monthly premium costs with their employees, and in exchange, the policy pays for covered healthcare services up to a specified amount. Employer health plans are a cost-effective healthcare solution that ensures your employees have the coverage they need to maintain their wellbeing and financial stability throughout the course of their employment.
There are several factors that influence the cost of group health insurance plans, including:
- Coverage limits
- Number of employees
- Shared costs
- Supplemental coverages (e.g. dental or vision)
At KSA Insurance, we work with businesses in South Carolina and across the southeastern United States to help them find personalized group health plans that meet their coverage needs and financial requirements.
Request a Quote
South Carolina residents are required to have health insurance, and while employers are not typically obligated to provide it, doing so can help them attract and retain talented employees, improve office morale, and qualify for certain tax credits.
KSA Insurance is licensed with Blue Cross, Blue Choice, Cigna, United Healthcare, National General, and Trustmark, and we work with most major group insurance carriers to help employers find policies that meet their unique needs.
Contact KSA Insurance today to request a quote and learn more about our insurance products for employers.