Do Affordable Care Act business requirements apply to “control groups?”
"Yes, it applies to control groups.  If I remember correctly common ownership rules are used to determine ""Applicable Large Employer"" status but if the time comes to owe a penalty, only the actual entity missing the mark will owe a penalty, not the entire control group. This is an excerpt from Section 4980H (the section that lays out employer requirements and penalties) (16) Employer. The term employer means the person that is the employer of an employee under the common-law standard. See § 31.3121(d)-1(c). For purposes of determining whether an employer is an applicable large employer, all persons treated as a single employer under section 414(b), (c), (m), or (o) are treated as a single employer. Thus, all employees of a controlled group of entities under section 414(b) or (c), an affiliated service group under section 414(m), or an entity in an arrangement described under section 414(o), are taken into account in determining whether the members of the controlled group or affiliated service group together are an applicable large employer. For purposes of determining applicable large employer status, the term employer also includes a predecessor employer (see paragraph (a)(36) of this section) and a successor employer. Link to the Federal Register"
Here are the SEC requirements: The federal securities laws define the term accredited investor in   Rule 501 of Regulation D as: a bank, insurance company, registered investment company, business development company, or small business investment company; an employee benefit plan, within the meaning of the Employee Retirement Income Security Act, if a bank, insurance company, or   registered investment adviser makes the investment decisions, or if   the plan has total assets in excess of $5 million; a charitable organization, corporation, or partnership with assets exceeding $5 million; a director, executive officer, or general partner of the company selling the securities; a business in which all the equity owners are accredited investors; a natural person who has individual net worth, or joint net worth with the person’s spouse, that exceeds $1 million at the time of the   purchase, excluding the value of the primary residence of such person; a natural person with income exceeding $200,000 in each of the two most recent years or joint income with a spouse exceeding $300,000 for   those years and a reasonable expectation of the same income level in   the current year; or a trust with assets in excess of $5 million, not formed to acquire the securities offered, whose purchases a sophisticated person makes. No citizenship/residency requirements. "When it's actually in the interests of taxpayers, duespayers, or shareholders for execs to upgrade to get work done / be prepared, there's no conflict between the interests of agent and principal, and the entire issue is moot.  But assuming we should treat business execs as a special case doesn't address the question. If governmental and union leadership ""should fly coach"", shouldn't c-corp execs?" Doesn't matter what the product is, whether it's a tangible good or a service, a business is still a business and must be run as thus. If you don't run a hospital properly, as a business that provides a service, then that hospital is soon to be threatened with closure or state take-over. Americans with Disabilities Act (ADA) specifies wheelchair ramp requirements as well as access guidelines, specifications that most business organizations which are into the manufacturing of ramps have to meet. Usually, residential applications don’t need to meet ADA requirements, guidelines and specifications. The insurance company is must assume you do have a preexisting condition you are unaware of.  The reason for that is that Affordable Care Act precludes the Insurance company from denying coverage of them if you do.  Insurance companies are businesses.  They are in business to make money(unless you have a nonprofit insurer).  They can not do that if you can buy insurance only when you need for them to pay out.  So even though you may not have a preexisting condition, they are precluded from requiring an examination that would detect the most expensive preexisting conditions (hidden cancers, neurological, autoimmune disorders).  So the companies must do what takes business sense and either deny you coverage or charge a rate that covers the risk they would be forced to take.   In your question on travel there was a response that suggested you get international health insurance instead of travel health insurance that would be considered credible coverage.  You are trying to save money which on a personal level is a good idea.  However that is against the societal and business need that you maintain health coverage during your healthy times to cover the costs of those who need expensive treatment.  So you will be monetarily penalized should you choose to reenter the society of insured people.  Once you have paid the higher rate for up to 18 months you should be able to get a better policy for people who have had continuous coverage.  Alternately you may be lucky enough to start working for a company that provides health insurance with out requiring continuous coverage. "Agreed, but often it seems that gray area is exactly what these ""innovations"" are looking for.  Repeatedly pushing down onto the struggling individual the past responsibilities of the wealthy corporation.    Say this thing picks up steam and is revitalizing Walmart.  John is walking out the door and ""critical"" deliveries need to be made.  John was a bit short last month and couldn't wait for the 2 week insurance reimbursement process.  So despite the team lead's prodding, didn't upgrade his insurance coverage this month.  He didn't want to be ""that guy"" so didn't confirm/deny getting modifying coverage to the lead.  The team lead asks John to take the packages, but doesn't really follow through on the insurance check.  John wrecks his car and his back.  John's insurance company rejects the claim.  The team lead and John are fired because not checking/having the insurance was against written policy, but winked and nodded away all the way back up to the #1 online retailer spot.  So often, obstacles are easily surmounted.  I get the ""personal responsibility"" angle for all involved, but social/financial pressure can be brutal.  The problem is that situations are left as is and the moneyed parties are ""enrichingly ignorant"".  My guess is few compile stats on SOL Uber/Lyft drivers in similar situations." I dont think we disagree. I believe the notion of control is elusive in this day and age. We have leverage or influence at best. I agree that if the government is asked to invest or subsidize in another organization, it has the right, as should any investor, to expect that its opinions will be heard and its interests will be protected. In that context, if any investor decides that its interests extend to amending management compensation, I think that is reasonable. Despite the ACA offering generous deductions, a lot of small businesses still cannot afford the initial capital involved in offering health insurance plan to their employees... Therefore we cannot take advantage of these deductions...  Putting us at a disadvantage for finding low-to-mid skilled workers, to the larger corporations that are now mandated to offer the benefits.. That's your assumption, but the details are there are different tiers of liability depending on the level of employees you have. Have 5,000+ you must pay this increased level of medical insurance or other liabilities.   So if he has 7,000 employees and increased liabilities would happen at 5,000+ ---- sounds like there's a $$ incentive to decrease to 4,999.   That's not emotion, that's just business.  The irony would be if he sold to a Chinese company, that cuts employee benefits and wages and sends most of the profit home while employing tax shelters to yield as little as possible in taxes. I don't have preexisting conditions. I am only speaking of how *my own personal* healthcare situation got worse because of the ACA.   I did used to use the dental and vision portions of my company-provided insurance regularly but I don't have that as part of my ACA insurance because again, it is unaffordable. By extending your logic both BNSF and GEICO would be nearly thhe same companies as both have majority ownership of warren buffet. How companies act IS defined by the theater of competition and regulation. Sears ca and US are two very different companies with no operational overlap (other than sears brand name) The tax incentives for employer sponsored health insurance were designed to incentivize employers to provide the insurance and for employees to purchase the insurance.  Since your situation does not meet the requirements to take advantage of this incentive, you can not.  In the near future you should be able to take part in the government sponsored exchanges.  This may spur changes in how this works. There are a lot of moving parts, individual premiums and annual increases have little to do with employer premiums and annual increases and vice versa.  Most people think of XYZ insurer as a single company with a single pool of insured folks.  This common knowledge isn't accurate.  Insurers pool their business segments separately.  This means that Individual, small business, mid-size business, and large business are all different operating segments from the viewpoint of the insurer.    It's possible to argue that because so many people are covered by employer plans that individual plans have a hard time accumulating the required critical mass of subscribers to keep increases reasonable.   Age banded rating: Individual coverage and small group coverage is age rated, meaning every year you get older.  In addition to your age increase, the premium table for your plan also receives an increase.  Employers with 100+ eligible employees are composite rated (in general), meaning every employee costs the same amount.  The 18 year old employee costs $500 per month, the 64 year old costs $500 per month.  Generally, the contributions an employee pays to participate in the plan are also common among all ages.  This means that on a micro level increases can be more incremental because the employer is abstracting the gross premium.  Composite rating generally benefits older folks while age rating generally benefits younger folks. Employer Morale Incentive: Generally the cost to an employee covered by an employer plan isn't directly correlated to the gross premium, and increases to the contribution(s) aren't necessarily correlated to the increases the employer receives.  Employers are incentivised by employee morale.  It's pretty common for employers to shoulder a disproportionate amount of an increase to keep everyone happy.  Employers may offset the increase by shopping some ancillary benefit like group life insurance, or bundling the dental program with the medical carrier.  Remember, employees don't pay premiums they pay contributions and some employers are more generous than others.  Employers are also better at budgeting for planned increases than individuals are. Regulators: In many of the states that are making the news because of their healthcare premium increases there simply isn't a regulator scrutinizing increases.  California requires all individual and small group premiums to be filed with the state and increases must be justified with some sort of math and approved by a regulator.  Without this kind of oversight insurers have only the risk of subscriber flight to adjust plan provisions and press harder during provider contract negotiations. Expiring Transitional Reinsurance Fee and Funds: One of the fees introduced by healthcare reform paid by insurers and self-insured employers established a pot of money that individual plans could tap to cope with the new costs of the previously uninsurable folks.  This fee and corresponding pot of money is set to expire and can no longer be taken in to account by underwriters. Increased Treatment Availability: It's important that as new facilities go online, insurer costs will increase.  If a little town gets a new cancer clinic, that pool will see more cancer treatment costs simply as a result of increased treatment availability.  Consider that medical care inflation is running at about 4.9% annually as of the most recent CPI table, the rest of the increases will result from the performance of that specific risk pool.  If that risk pool had a lot of cancer diagnoses, you're looking at a big increase.  If that risk pool was under priced the prior year you will see an above average increase, etc. "It's required by law.  12 USC 1759 (b) requires that membership in a credit union be limited to one or more groups with a ""common bond"", or to people within a particular geographic area. For lots more gory details on how this is interpreted and enforced, you can read the manual given to credit unions by the National Credit Union Administration, which is their regulatory agency." "J Gruber's consulting reports for the various states (Minnesota, Wisconsin, etc).  * http://www.washingtonpost.com/blogs/ezra-klein/post/jon-gruber-on-the-premiums-in-health-care-reform/2011/08/25/gIQAN0TUWS_blog.html  ...and the article it addresses (which included some numbers from the reports):  * http://dailycaller.com/2012/02/11/obamacare-architect-expect-steep-increase-in-health-care-premiums/  Note that Gruber has made a whole spectrum of claims (from initially claiming that premiums would go DOWN for a consulting agreement with the Obama administration, to later ""revisions"" showing significant increases {to varying degrees depending on the individuals specific demographic}), to wit:  &gt;Gruber’s new reports are in direct contrast Obama’s words — and with claims Gruber himself made in 2009. Then, the economics professor said that based on figures provided by the independent Congressional Budget Office, “[health care] reform will significantly reduce, not increase, non-group premiums.”  &gt;During his presentation to Wisconsin officials in August 2011, Gruber revealed that while about 57 percent of those who get their insurance through the individual market will benefit in one way or another from the law’s subsides, an even larger majority of the individual market will end up paying drastically more overall.  &gt;“After the application of tax subsidies, **59 percent of the individual market will experience an average premium increase of 31 percent,”** Gruber reported.  &gt;The reason for this is that an estimated 40 percent of Wisconsin residents who are covered by individual market insurance don’t meet the Affordable Care Act’s minimum coverage requirements. Under the Affordable Care Act, they will be required to purchase more expensive plans.  &gt;Asked for his own explanation for the expected health-insurance rate hikes, Gruber told TheDC that his reports “reflect the high cost of folding state high risk pools into the [federal government's] exchange — without using the money the state was already spending to subsidize those high risk pools.”  Note: Emphasis added.    Note 2: To begin with, an ""average"" increase of 31% qualifies as ""significant"" (hell, it's a lot more than merely ""significant"", that's a HUGE increase); and secondly, that is an AVERAGE, meaning that while some of the people in that ""59%"" will probably not see such a high increase, a fairly large segment {and per the provisions of the Act versus current premium calculation methods, we KNOW these will be ""young healthy singles"", and especially males} will face increases that are substantially HIGHER than 31%, and in fact will probably be in the nature of double or triple previous premiums {as would be required in order to meet another provision of the act, that highest premiums for older/sicker pool members cannot be higher than 3x that of the youngest/lowest tier premiums -- and if the company is to balance the books, it can only ""bring down"" the one end if it makes a compensating increase at the other end.})  None of that is ""rocket science"" and it is entirely predictable. (The only things that would be ""odd"" would be that anyone should expect anything different, and that Gruber's initial claims of across the board lower costs were ever accepted in the first place.)"