Group Benefits · Wisconsin
The 50-Employee Line: When a Wisconsin Business Must Offer Health Insurance
Federal law does not order any business to buy health insurance. What it does — through section 4980H of the Internal Revenue Code — is charge a tax to employers above a certain size that don't offer it, once an employee goes to the Marketplace and qualifies for a premium tax credit. That size is 50, and it is the most misread number in small-business benefits, because it is not a headcount. It is an average of last year's months, it counts part-time hours you may not think of as employees at all, and the number that determines whether you owe anything is a different number from the one that puts you over the line. Here is each calculation, with the 2027 dollar figures the IRS has already published.
TL;DR — Key takeaways
- The test is an average of the preceding calendar year, month by month, divided by 12 and rounded down (26 CFR § 54.4980H-2(b)(1)). What you employ today does not decide this year's status.
- Full-time means averaging 30 hours of service a week, or 130 hours in a calendar month (§ 54.4980H-1(a)(21)).
- Part-time hours roll up into full-time equivalents: total the month's hours for everyone who isn't full-time, cap each person at 120, divide by 120 (§ 54.4980H-2(c)(2)).
- FTEs count toward the 50 but never toward the bill. The penalty is calculated on full-time employees only, minus your allocable share of 30 (§ 54.4980H-4(e)).
- Nothing is owed unless an employee receives a premium tax credit and you get a Section 1411 Certification. No certification, no payment.
- 2027 amounts: $3,780 a year ($315/month) under 4980H(a); $5,670 a year ($472.50/month) under 4980H(b) (Rev. Proc. 2026-22).
- Affordability for plan years beginning in 2027 is tested at 10.22%, up from 9.96% for 2026 (Rev. Proc. 2026-26).
- A seasonal workforce can push you over 50 for up to 120 days — four calendar months, not necessarily consecutive — without making you an applicable large employer.
What the law actually requires
"Employer mandate" is the common name, and it oversells what the statute does. Section 4980H does not compel anyone to sponsor a health plan. It creates an assessable payment — a tax — that applies to an applicable large employer when two things happen together: the employer fails to offer adequate coverage to its full-time employees, and at least one of those employees buys a Marketplace plan with a premium tax credit.
That second condition is a real gate, not a formality. Both penalty regulations hang on what § 54.4980H-1(a) calls a Section 1411 Certification — "the certification received as part of the process established by the Secretary of Health and Human Services under which an employee is certified to the employer under section 1411 of the Affordable Care Act as having enrolled for a calendar month in a qualified health plan with respect to which an applicable premium tax credit or cost-sharing reduction is allowed or paid." No employee claims a credit, no certification issues, and no payment is assessed — however large the employer and however thin the benefits.
Three consequences follow, and they shape everything below.
- Your exposure tracks your employees' Marketplace behavior, not just your plan design. An offer that is technically deficient costs nothing until someone acts on it.
- The arithmetic runs on last year. Status for 2027 is settled by what happened in 2026 — which is why this is an autumn conversation.
- Two different employee counts matter. One decides whether the rules apply to you. The other decides the size of the bill. Confusing them is the single most common error we see.
One more definition worth knowing early. An offer has to extend to employees and their dependents — but § 54.4980H-1(a) defines a dependent as a child who has not attained age 26 and then says plainly: "The term dependent does not include the spouse of an employee." Spousal coverage is a competitive and retention decision. It is not what section 4980H is measuring.
The 50-employee test, step by step
Section 54.4980H-2(b)(1) lays out the whole calculation in one sentence. An employer's status "is determined by taking the sum of the total number of full-time employees (including any seasonal workers) for each calendar month in the preceding calendar year and the total number of FTEs (including any seasonal workers) for each calendar month in the preceding calendar year, and dividing by 12. The result, if not a whole number, is then rounded to the next lowest whole number."
Unpacked, that is four steps:
- For each of last year's twelve months, count your full-time employees. Full-time means an average of at least 30 hours of service per week. Section 54.4980H-1(a)(21) adds the conversion most payroll systems actually use: "130 hours of service in a calendar month is treated as the monthly equivalent of at least 30 hours of service per week."
- For each of those months, compute your full-time equivalents from everyone else's hours. The method is in the next section.
- Add all twenty-four monthly numbers and divide by 12.
- Round down. Not to the nearest whole number — to the next lowest. An employer averaging 50.9 is an applicable large employer at 50. An employer averaging 49.97 is not.
Two structural points sit underneath this. First, the count is made across a controlled group. The regulation applies the aggregation rules of sections 414(b), (c), (m) and (o), so commonly owned companies are added together for the threshold even though each entity — each "applicable large employer member" — is separately liable for its own employees. The regulation's own first example makes the point: a parent with no employees and two subsidiaries with 40 and 60 full-time employees produces one applicable large employer of 100, and all three entities are members of it.
Second, a business that did not exist for any business day of the prior year has no prior-year average to use. Under § 54.4980H-2(b)(3) it is an applicable large employer for the current year if it reasonably expects to average at least 50 and actually does.
Crossing the line for the first time buys you a quarter. Section 54.4980H-2(b)(5) gives first-year relief: for an employee who was offered no coverage at any point in the prior calendar year, offering coverage on or before April 1 of your first year as an applicable large employer avoids a 4980H(a) payment for January through March. Miss April 1 and those three months come back into the calculation. The relief applies only to a first year — not to an employer that drops below 50 and climbs back.
How part-time hours become full-time equivalents
This is the step that surprises employers, and it is mechanical. Section 54.4980H-2(c)(1) defines the pool: "All employees (including seasonal workers) who were not employed on average at least 30 hours of service per week for a calendar month in the preceding calendar year are included in calculating the employer's FTEs for that calendar month."
Section 54.4980H-2(c)(2) then does the arithmetic. For each month, aggregate the hours of service of those non-full-time employees — "but not more than 120 hours of service for any employee" — and divide by 120. Fractions count; you may round each month's FTE figure to the nearest one hundredth.
Three things fall out of that wording that are easy to miss:
- Every non-full-time employee is in the pool, no matter how few hours they worked. There is no floor. A student working six shifts over a summer month contributes those hours.
- The 120-hour cap is not the same as the 130-hour full-time line. An employee at 125 hours in a month is not full-time — 130 is the threshold — but contributes only 120 hours to the FTE pool. The ten hours in between vanish from the calculation entirely.
- Seasonal workers are counted here too. They are explicitly included in the pool. The seasonal relief, when it applies at all, comes later and works differently.
The IRS supplies its own worked example at § 54.4980H-2(d), Example 2, and it is the cleanest illustration of the whole test. An employer has 20 full-time employees averaging 35 hours a week, plus 40 employees each averaging 90 hours of service a calendar month, and no seasonal workers. The 40 part-timers produce 3,600 hours; 3,600 ÷ 120 = 30 FTEs. Twenty full-time employees plus thirty FTEs is exactly 50 — and that employer is an applicable large employer for the following year.
Two businesses, one line between them
Here are two employers of roughly the same size, built to show how little separates them. Both are illustrative — the headcounts and hours are chosen to make the arithmetic visible, not drawn from any real business, and neither is a quote or a benchmark.
| Step | Employer A | Employer B |
|---|---|---|
| Full-time employees, every month | 38 | 30 |
| Other employees | 22, averaging 80 hours/month | 24, averaging 96 hours/month |
| Monthly part-time hours | 22 × 80 = 1,760 | 24 × 96 = 2,304 |
| FTEs (hours ÷ 120) | 1,760 ÷ 120 = 14.67 | 2,304 ÷ 120 = 19.20 |
| Monthly total | 38 + 14.67 = 52.67 | 30 + 19.20 = 49.20 |
| Twelve-month average, rounded down | 52 | 49 |
| Applicable large employer? | Yes | No |
| Full-time employees used for any penalty | 38 | — |
| After the 30-employee reduction | 8 | — |
| Maximum 2027 exposure under 4980H(a) | 8 × $3,780 = $30,240 | $0 |
Illustrative only — headcounts and hours are hypothetical inputs chosen to show the method, not quotes, recommendations or benchmarks. Method: 26 CFR § 54.4980H-2(b)(1) and (c)(2). Dollar amount: Rev. Proc. 2026-22 (2027). An actual 4980H(a) payment also requires a Section 1411 Certification.
Notice what Employer A's bill is built from. Fifty-two people put it over the line — but the payment is calculated on 38, reduced by 30, leaving 8. The twenty part-timers whose hours created applicable large employer status contribute nothing to the amount owed. That gap between 52 and 8 is the structural fact worth carrying away from this article.
Notice, too, how close Employer B is. Four more part-time hires at the same schedule, or a modest increase in everyone's hours, moves them across. The threshold is not a cliff you can only fall off deliberately.
The seasonal exception
Western Wisconsin has a lot of businesses whose payroll swells for part of the year — agriculture, construction, tourism, retail at the holidays. Section 54.4980H-2(b)(2) exists for them, and it is narrower than its reputation.
The exception applies if the sum of full-time employees and FTEs "exceeds 50 for 120 days or less during the preceding calendar year, and the employees in excess of 50 who were employed during that period of no more than 120 days are seasonal workers." Both halves must hold. The regulation then adds a useful measurement convenience: "For purposes of this paragraph (b)(2) only, four calendar months may be treated as the equivalent of 120 days. The four calendar months and the 120 days are not required to be consecutive."
The IRS's Examples 3 and 4 show exactly where the exception breaks. In Example 3 an employer has 40 full-time employees all year and 80 seasonal full-time workers from September through December — an annual average of 66.67. The exception applies, because the overage lasted four calendar months and the count drops below 50 once seasonal workers are set aside. In Example 4 the same employer also has 20 FTEs in August. That one extra month puts the workforce above 50 for more than four calendar months, the exception fails entirely, and the employer is an applicable large employer with an average of 68.
One further definition matters here. A seasonal worker for this test is defined by reference to the Secretary of Labor's standard at 29 CFR 500.20(s)(1), including retail workers employed exclusively during holiday seasons, and employers may apply "a reasonable, good faith interpretation" of it. Do not confuse it with the separate term seasonal employee, which § 54.4980H-1(a) defines as someone "hired into a position for which the customary annual employment is six months or less" and which is used for measuring full-time status, not for this exception.
What you owe if you offer nothing
Section 54.4980H-4 handles the first penalty — the one for failing to make an offer at all. It applies when an applicable large employer member fails to offer its full-time employees and their dependents the chance to enroll in minimum essential coverage for a month, and has received a Section 1411 Certification for at least one full-time employee.
The offer threshold is not 100 percent. The regulation treats an employer as offering coverage for a month if it offers "to all but five percent (or, if greater, five) of its full-time employees" — the 95 percent rule, with a floor of five employees that gives very small applicable large employers a little more room.
The payment is the 4980H(a) applicable payment amount multiplied by the employer's full-time employees for the month — and then paragraph (e) applies the reduction that matters most:
§ 54.4980H-4(e): "an applicable large employer member's number of full-time employees is reduced by that member's allocable share of 30." Across a controlled group the 30 is allocated ratably by each member's full-time employee count and rounded up to the next whole number — which the regulation notes may make the group's total reduction exceed 30.
Full-time equivalents appear nowhere in that sentence. They got you into the regime; they are absent from the bill.
2027 employer shared responsibility amounts, per employee
Source: IRS Rev. Proc. 2026-22, applying the premium adjustment percentage of 1.8916224814 to the statutory $2,000 and $3,000 amounts under 26 U.S.C. §§ 4980H(c)(1) and 4980H(b)(1) and rounding down to the next lowest multiple of $10. Amounts are annual per-employee figures for calendar year 2027; both are assessed monthly at one twelfth. A payment arises only where the employer has received a Section 1411 Certification.
Two timing rules round this out. Under § 54.4980H-4(c), failing to offer coverage for any day of a month means the employee is treated as not offered coverage for the whole month — though an employee whose employment ends mid-month, and who would have had coverage for the full month otherwise, is treated as covered for all of it. And an employee whose start date falls on any day other than the first of the month is excluded from the 4980H(a) calculation for that month.
What you owe if your offer falls short
Section 54.4980H-5 covers the employer who did offer coverage — to at least 95 percent of full-time employees — but whose offer was either unaffordable or failed minimum value. This penalty is charged per employee, not across the workforce: the 4980H(b) amount multiplied by the number of full-time employees for whom the employer received a Section 1411 Certification, excluding anyone who was offered minimum-value coverage meeting one of the affordability safe harbors.
It also has a ceiling. The same paragraph provides that the aggregate 4980H(b) payment for a month "may not exceed the product of the section 4980H(a) applicable payment amount and the number of full-time employees of the applicable large employer member during that calendar month (reduced by the applicable large employer member's ratable allocation of the 30 employee reduction)." A partial offer can never cost more than offering nothing. And under § 54.4980H-4(d), an employer may be liable under 4980H(a) or 4980H(b) for a given month, "but will not be liable for an assessable payment under both."
Minimum value is two tests, not one
Employers often treat minimum value as a single actuarial percentage. It is not. Under 26 CFR § 1.36B-6(a), a plan provides minimum value only if both conditions are met: the plan's minimum value percentage "is at least 60 percent based on the plan's share of the total allowed costs of benefits provided to the employee," and "[t]he plan provides substantial coverage of inpatient hospital services and physician services." A plan can clear 60 percent on paper and still fail the second prong. If you are being shown a low-cost design that trims hospital benefits, that is the clause to ask about by name.
The three affordability safe harbors
Affordability under section 36B is measured against the employee's household income — a figure no employer has. Section 54.4980H-5(e)(2) solves that with three optional safe harbors. Use one and you are protected from a 4980H(b) payment for that employee even if the coverage turns out to be unaffordable against their actual household income.
First, the percentage. The regulation text prints 9.5 percent, and that printed figure is out of date by design. IRS Notice 2015-87, Q&A-12, states that "[t]he 9.5 percent standard set forth in each of the affordability safe harbors is derived from § 36B(c)(2)(C)(i)" and that Treasury and the IRS "intend to amend the regulations under § 4980H to reflect that the applicable percentage in the affordability safe harbors should be adjusted consistent with § 36B(b)(3)(A)(ii)." So the live number is the indexed one:
- Plan years beginning in 2026: 9.96% (Rev. Proc. 2025-25 § 3.02)
- Plan years beginning in 2027: 10.22% (Rev. Proc. 2026-26 § 3.02)
A rising percentage means an employer may charge a somewhat larger share of pay before an offer becomes unaffordable. It does not mean the coverage got cheaper for the employee.
| Safe harbor | Measured against | Practical note |
|---|---|---|
| Form W-2 § 54.4980H-5(e)(2)(ii) | The employee's Form W-2 wages from the employer for the calendar year | Applied after year end, employee by employee. The required contribution must stay a consistent amount or percentage all year — you may not make discretionary mid-year adjustments. Partial-year offers are prorated by months. |
| Rate of pay § 54.4980H-5(e)(2)(iii) | 130 hours × the lower of the hourly rate at the start of the coverage period or the lowest hourly rate in the month | Usable prospectively, which is why most employers design to it. For non-hourly employees it uses monthly salary at the start of the coverage period — and the safe harbor is lost if that salary is reduced. |
| Federal poverty line § 54.4980H-5(e)(2)(iv) | The federal poverty line for a single individual for the applicable calendar year, divided by 12 | One number for your whole workforce, and the simplest to administer. Set the employee contribution at or below it and every full-time employee is covered by the safe harbor. |
Source: 26 CFR § 54.4980H-5(e)(2), with the percentage indexed per IRS Notice 2015-87 Q&A-12. Use of a safe harbor is optional and requires an offer of minimum-value coverage; an employer may apply a safe harbor to "any reasonable category of employees" — job category, hourly versus salaried, geographic location and similar bona fide business criteria — provided it does so uniformly within the category. Listing employees by name is expressly not a reasonable category.
The federal poverty line safe harbor, in dollars. HHS set the 2026 poverty guideline for a household of one in the 48 contiguous states and DC at $15,960 (91 FR 1797, January 15, 2026). Divided by 12 that is $1,330.00 a month; at the 2026 percentage of 9.96% the safe harbor ceiling works out to about $132.47 per employee per month for self-only, minimum-value coverage. HHS publishes the 2027 guideline each January, so the 2027 version of this figure does not exist yet — budget against the 2026 number and revisit it when the new guideline is issued.
How many local employers sit near the line
The 50-employee threshold sounds remote until you look at how business sizes are actually distributed. In La Crosse County, the Census Bureau's 2023 County Business Patterns counted 3,151 establishments employing 66,633 people. Here is how those establishments break down by size.
La Crosse County establishments by employment size, 2023
Source: U.S. Census Bureau, County Business Patterns 2023, La Crosse County, Wisconsin (FIPS 55063), all industries. The "100 or more" bar combines the 100–249 (67), 250–499 (27), 500–999 (6) and 1,000-or-more (5) size classes. Important: County Business Patterns counts establishments — physical locations — not firms, and section 4980H counts employees across an entire controlled group. These counts are context for how local business sizes are distributed, not a count of applicable large employers.
Read with that caveat in mind, the shape is still informative. The 20-to-49 band is the largest of the mid-size groups at 400 establishments — businesses for which the 50-employee test is a live annual question rather than a settled one, particularly any that lean on part-time or seasonal staffing. Another 136 sit in the 50-to-99 band, where the answer is likely yes and the practical work is making sure the offer itself holds up.
The forms — and the rule that changed
Applicable large employer status brings a filing obligation whether or not any payment is ever assessed. Each applicable large employer member files Form 1094-C with the IRS and a Form 1095-C for each full-time employee, documenting the coverage offered month by month.
The part worth knowing is a change many employers still have not absorbed. The IRS instructions for Forms 1094-C and 1095-C now state: "Effective January 31, 2024, employers no longer have to automatically send Form 1095-C to individuals. Employers can now post a notice on its website informing individuals that they may request a copy of the statement."
That alternative is not a free pass — it has specific conditions. Per the instructions, the website notice must be clear, conspicuous and reasonably accessible; it must include a statement on the main page, or a link on the main page reading "Tax Information," leading to a page carrying the words "IMPORTANT HEALTH COVERAGE TAX DOCUMENTS" in capital letters; it must explain how to request a copy; and it must list the employer's email address, mailing address and telephone number. For tax year 2025 the notice had to be posted by March 2, 2026 and kept in the same location through October 15, 2026, and a requested statement must be furnished within 30 days of the request.
Filing with the IRS is unchanged. For tax year 2025 returns the deadlines were March 2, 2026 on paper and March 31, 2026 electronically. The IRS publishes each year's dates with that year's instructions — check them rather than carrying last year's forward.
If you're under 50
Nothing in section 4980H reaches you. That is worth stating plainly, because a good share of the benefits anxiety we hear from western Wisconsin employers comes from businesses the provision does not touch at all.
What may reach you instead is a credit. The IRS small business health care tax credit is available to employers that have fewer than 25 full-time equivalent employees, pay average annual wages below an inflation-adjusted ceiling, offer a qualified health plan through a SHOP Marketplace (or qualify for a limited exception), and pay at least 50 percent of the cost of employee-only coverage. The maximum credit is 50 percent of premiums paid — 35 percent for tax-exempt employers — and it is available for two consecutive taxable years. It scales down as the employer grows, so the smallest employers get the most.
One honest caveat on the wage ceiling: the IRS's own published table of inflation-adjusted amounts runs through tax year 2023, where it stood at $62,000. Confirm the current year's figure with the IRS or your CPA before relying on the credit in a budget.
And if a traditional group plan is not the right fit at your size, defined contribution is the other path worth pricing. We covered the mechanics separately in our guide to how an ICHRA works in Wisconsin — an arrangement with no employer size minimum and no cap on what you may contribute. Note the connection to this article: an applicable large employer offering an ICHRA is making an offer of coverage for section 4980H purposes, so the affordability question above follows you into that design.
Eight questions before January
- Have we actually run the twelve-month average, or are we going by current headcount? These are different numbers and only one of them is the test.
- Are we capturing hours of service for every non-full-time employee, including short-tenure and seasonal staff? There is no minimum-hours floor on the FTE pool.
- Are commonly owned entities being aggregated under sections 414(b), (c), (m) and (o) for the threshold?
- If we are close to 50, do we know which side we landed on — and that the rounding is down, not to the nearest?
- If we rely on the seasonal exception, does the overage really fit inside 120 days or four calendar months, counting every month the workforce exceeded 50?
- Does our offer reach at least 95 percent of full-time employees and their dependent children to age 26?
- Does the plan clear both minimum value prongs — 60 percent and substantial coverage of inpatient hospital and physician services?
- Which affordability safe harbor are we designing to, at 10.22% for plan years beginning in 2027, and is it applied uniformly within a reasonable category?
Not sure which side of 50 you're on? The calculation takes a payroll export and an hour, and the answer is worth having before you renew rather than after. We will run your prior-year average, flag whether the seasonal exception is available to you, and test your current or proposed employee contribution against the 2027 safe harbor percentage. Call or text (608) 799-8434, or schedule a conversation. You can also compare approaches with our group vs. ICHRA comparison tool.
Frequently asked questions
How many employees before a business has to offer health insurance?
Fifty, but the count is not a headcount. Under 26 CFR § 54.4980H-2(b)(1) you add up your full-time employees for each calendar month of the preceding calendar year, add your full-time equivalents for each of those months, divide by 12, and round down to the next lowest whole number. If the result is 50 or more you are an applicable large employer for the current year. A full-time employee is one averaging at least 30 hours of service per week, and § 54.4980H-1(a)(21) treats 130 hours of service in a calendar month as the monthly equivalent. Nothing in federal law orders you to buy a plan even then — section 4980H imposes a tax payment if you do not offer coverage and at least one full-time employee receives a premium tax credit through the Marketplace.
Do part-time employees count toward the 50-employee threshold?
Toward the threshold, yes. Toward the penalty, no. Under 26 CFR § 54.4980H-2(c)(2), you add up the hours of service of everyone who is not a full-time employee for a given month, counting no more than 120 hours for any one person, and divide by 120. That is your full-time equivalent count for the month, and it goes into the 50-employee test. But the assessable payment under § 54.4980H-4 is calculated on full-time employees only, reduced by the employer's allocable share of 30. Part-timers can make you an applicable large employer and still contribute nothing to what you owe.
What is the employer shared responsibility penalty for 2027?
Rev. Proc. 2026-22 sets both figures. The section 4980H(a) amount — the one that applies if you do not offer minimum essential coverage to at least 95 percent of your full-time employees and at least one of them receives a premium tax credit — is $3,780 for calendar year 2027, or $315 per month, multiplied by your full-time employees after subtracting your allocable share of 30. The section 4980H(b) amount — which applies when you did offer coverage but it was unaffordable or failed minimum value — is $5,670 for 2027, or $472.50 a month, charged only for each full-time employee who actually receives a premium tax credit. Under § 54.4980H-5(a) the total (b) payment can never exceed what the (a) payment would have been, and § 54.4980H-4(d) confirms you can be liable under one or the other in a month, never both.
What makes an offer of coverage affordable for employer mandate purposes?
Affordability is measured against the employee's household income, which employers do not know, so 26 CFR § 54.4980H-5(e)(2) gives three safe harbors you may use instead: the employee's Form W-2 wages, a rate of pay calculation using 130 hours a month, or the federal poverty line for a single individual. The regulation prints the threshold as 9.5 percent, but IRS Notice 2015-87 Q&A-12 confirms that figure is indexed along with section 36B. Rev. Proc. 2026-26 sets the percentage at 10.22% for plan years beginning in 2027, up from 9.96% for 2026. The safe harbors are optional, you may apply them to any reasonable category of employees, and you must apply them uniformly within a category.
Does an employer under 50 employees get anything for offering coverage?
Possibly a tax credit. The IRS small business health care tax credit is available to employers with fewer than 25 full-time equivalent employees who pay average wages below an inflation-adjusted ceiling, offer a qualified health plan through a SHOP Marketplace, and pay at least 50 percent of the cost of employee-only coverage. The maximum credit is 50 percent of premiums paid, or 35 percent for tax-exempt employers, and it is available for two consecutive taxable years. The credit scales down as the employer gets larger, so it is worth the most to the smallest employers. Confirm the current year's average wage ceiling with the IRS or your CPA before relying on it.
Sources
- Internal Revenue Service. 26 CFR § 54.4980H-1 — Definitions (full-time employee, dependent, seasonal worker, seasonal employee, Section 1411 Certification). ecfr.gov
- Internal Revenue Service. 26 CFR § 54.4980H-2 — Applicable Large Employer and Applicable Large Employer Member (see (b)(1), (b)(2), (b)(5), (c)(2) and the examples at (d)). ecfr.gov
- Internal Revenue Service. 26 CFR § 54.4980H-4 — Assessable Payments Under Section 4980H(a) (see (a), (c), (d) and (e)). ecfr.gov
- Internal Revenue Service. 26 CFR § 54.4980H-5 — Assessable Payments Under Section 4980H(b) (see (a) and the safe harbors at (e)(2)). ecfr.gov
- Internal Revenue Service. 26 CFR § 1.36B-6 — Minimum Value. ecfr.gov
- Internal Revenue Service. Rev. Proc. 2026-22 — indexing adjustments for the applicable dollar amounts under section 4980H for calendar year 2027. irs.gov
- Internal Revenue Service. Rev. Proc. 2026-26, § 3.02 — Required Contribution Percentage for plan years beginning in 2027. irs.gov
- Internal Revenue Service. Rev. Proc. 2025-25, § 3.02 — Required Contribution Percentage for plan years beginning in 2026, Internal Revenue Bulletin 2025-32. irs.gov
- Internal Revenue Service. Notice 2015-87, Q&A-12 — indexing of the 9.5 percent standard in the section 4980H affordability safe harbors. irs.gov
- Internal Revenue Service. Instructions for Forms 1094-C and 1095-C — alternative manner of furnishing, website notice requirements, and filing deadlines. irs.gov
- Internal Revenue Service. Questions and Answers on Employer Shared Responsibility Provisions Under the Affordable Care Act. irs.gov
- Internal Revenue Service. Small Business Health Care Tax Credit and the SHOP Marketplace. irs.gov
- U.S. Department of Health and Human Services. Annual Update of the HHS Poverty Guidelines, 91 FR 1797 (January 15, 2026). federalregister.gov
- U.S. Census Bureau. County Business Patterns, 2023 — La Crosse County, Wisconsin (FIPS 55063), establishments by employment size class, all industries, retrieved October 26, 2026. census.gov
Important disclosures: This article is for general information only and is not insurance, tax, legal, or benefits-compliance advice. Applicable large employer status, hours-of-service measurement, controlled group aggregation, plan design, and reporting obligations vary by employer and by workforce, and a conclusion that is correct for one business may not be for another — consult a licensed agent, your CPA, and benefits counsel before acting on anything here. The employer headcounts, part-time hours, and resulting dollar figures in the "Two businesses, one line between them" section are illustrative arithmetic inputs chosen to demonstrate the method; they are not quotes, recommendations, benchmarks, or predictions of any employer's liability, and an actual assessable payment additionally requires a Section 1411 Certification. The County Business Patterns figures count establishments rather than firms and are not a count of applicable large employers. Regulatory citations reflect the Code of Federal Regulations as in force at the time of writing, together with Rev. Proc. 2026-22, Rev. Proc. 2026-26, Rev. Proc. 2025-25 and Notice 2015-87; federal rules, indexed percentages, poverty guidelines, and filing deadlines change annually. Hougom Insurance Agency is a licensed independent insurance agency (NPN 20742808) and does not offer every plan or product available in your area.