§ 10501. Purpose
For the purpose of more equitably distributing the costs of health care to uninsured
residents of this State, an employers’ Health Care Fund contribution is established
to provide a fair and reasonable method for sharing health care costs with employers
that do not offer their employees health care coverage and employers that offer insurance
but whose employees enroll in Medicaid. (Added 2017, No. 73, § 16, eff. Jan. 1, 2018.)
§ 10502. Definitions
As used in this chapter:
(1) “Employee” means an individual who is:
(A) 18 years of age or older for all of a calendar quarter;
(B) employed full-time or part-time; and
(C) reported by an employer for purposes of complying with Vermont unemployment compensation
law pursuant to 21 V.S.A. chapter 17.
(2) “Employer” means a person who is required to furnish unemployment insurance coverage
pursuant to 21 V.S.A. chapter 17.
(3)(A) “Full-time equivalent” or “FTE” means the number of employees expressed as the number
of employee hours worked during a calendar quarter divided by 520. The FTE calculation
shall be based on a 40-hour work week. No more than one FTE may be assessed against
an individual employee, regardless of the actual number of hours worked by that employee
during the calendar quarter.
(B) The hours worked during a calendar quarter means hours worked during all pay periods
in that quarter for which gross wages were reported and paid. Unworked hours, such
as vacation or sick time, may be excluded from the FTE calculation.
(C) “Full-time equivalent” shall not include any employee hours attributable to a seasonal
employee or part-time employee of an employer who offers health care coverage to all
of its regular full-time employees, provided that the seasonal employee or part-time
employee has health care coverage under either a private plan or any public plan except
Medicaid.
(4) “Health care coverage” shall mean any private or public plan that includes both hospital
and physician services.
(5) “Part-time employee” shall mean an employee who works for an employer for fewer than
30 hours a week or fewer than 390 hours in a calendar quarter.
(6) “Seasonal employee” means an employee who:
(A) works for an employer for 20 weeks or fewer in a calendar year; and
(B) works in a job scheduled to last 20 weeks or fewer.
(7) “Uncovered employee” means:
(A) an employee of an employer who does not offer to pay any part of the cost of health
care coverage for its employees;
(B) an employee who is not eligible for health care coverage offered by an employer to
any other employees; or
(C) an employee who is offered and is eligible for coverage by the employer but elects
not to accept the coverage and:
(i) is enrolled in Medicaid;
(ii) has no other health care coverage under either a private or public plan except Medicaid;
or
(iii) has purchased health insurance coverage as an individual through the Vermont Health
Benefit Exchange. (Added 2017, No. 73, § 16, eff. Jan. 1, 2018.)
§ 10503. Health Care Fund contribution assessment
(a) The Commissioner of Taxes shall assess and an employer shall pay a quarterly Health
Care Fund contribution for each full-time equivalent uncovered employee employed during
that quarter in excess of four full-time equivalent employees.
(b) The amount of the contribution shall be $158.77 for each full-time equivalent employee
in excess of four. Starting in calendar year 2018, the amount of the contribution
shall be adjusted annually by a percentage equal to any percentage change in premiums
for the second-lowest cost of all silver-level health benefit plans, whether offered
in or outside the Vermont Health Benefit Exchange.
(c) Health Care Fund contribution assessments under this chapter shall be determined on
a calendar quarter basis, due and payable on or before the 25th day of the calendar
month succeeding the close of each quarter. All administrative provisions of chapter
151 of this title shall apply to this chapter, except penalty and interest shall apply
according to chapter 103 of this title.
(d) Revenues from the Health Care Fund contributions collected shall be deposited into
the General Fund.
(e)(1) Notwithstanding any provision of law to the contrary, the Department of Taxes shall
provide the Joint Fiscal Office with all returns or return information relating to
the Health Care Fund contribution assessment, except information that would identify
a taxpayer. The information sharing required by this subsection shall occur quarterly
within a reasonable time following the return due date for each quarter.
(2) When handling information shared pursuant to this subsection, the Joint Fiscal Office
shall be subject to the same requirements and penalties as employees of the Department
of Taxes under section 3102 of this title. It shall be considered an unauthorized disclosure for an officer, employee, or agent
of the Joint Fiscal Office to disclose returns or return information provided pursuant
to this subsection that does not combine a taxpayer’s information with at least nine
other taxpayers. (Added 2017, No. 73, § 16, eff. Jan. 1, 2018; amended 2019, No. 6, § 74, eff. April 22, 2019.)
§ 10504. Hours worked by uncovered employees; calculation and reporting
(a) Employers shall report to the Department of Taxes the number of hours worked by each
uncovered employee on a return provided by the Department. The return shall be filed
at the same time payment is required under subsection 10503(c) of this chapter, shall
be filed electronically, and shall include any information required by the Commissioner.
(b) Quarterly health care contributions shall be calculated in the following manner:
(1) An employer shall divide the total hours worked by all uncovered employees during
a quarter by 520, to represent one full-time equivalent employee. The employer shall
then round the resulting number down to the nearest whole number and subtract four.
The employer shall then multiply the resulting number by the amount established under
subsection 10503(b) of this chapter to determine the amount of assessment due for
the quarter.
(A) For full-time salaried employees, employers shall use 520 hours a quarter for the
total hours worked.
(B) For all employees who worked more than 520 hours in a quarter, employers shall use
520 hours a quarter for the total hours worked.
(2) The Commissioner shall provide an electronic declaration of health care coverage form
for employers to collect the health coverage statuses of their employees for purposes
of this assessment. The form shall preserve the confidentiality of the type of coverage
possessed by the employee and the employer shall only use the form for purposes of
this assessment.
(A) An employer shall annually obtain a declaration of health care coverage from every
employee who is not enrolled in a plan offered by the employer.
(B) An employer shall maintain declarations of health care coverage for a minimum of three
years in a manner reasonably available for review and audit.
(C) Employees for whom no declaration of coverage is obtained shall be treated as uncovered.
(c) In the case of an employee leasing agreement, leased employees shall be considered
employees of a client company and not employees of an employee leasing company. (Added 2017, No. 73, § 16, eff. Jan. 1, 2018.)
§ 10505. Health benefit costs
(a) Employers shall provide their employees with an annual statement indicating:
(1) the total monthly premium cost paid for any employer-sponsored health benefit plan;
(2) the employer’s share and the employee’s share of the total monthly premium; and
(3) any amount the employer contributes toward the employee’s cost-sharing requirement
or other out-of-pocket expenses.
(b) Notwithstanding the provisions of subsection (a) of this section, an employer who
reports the cost of coverage under an employer-sponsored health benefit plan as required
by 26 U.S.C. § 6051(a)(14) shall be deemed to be in full compliance with the requirements of this section. (Added 2017, No. 73, § 16, eff. Jan. 1, 2018.)