Current through August, 2024
Section I Authority
Issued by Authority of and under the provisions of Section 34
of Act 191 of the 2006 Session of the Vermont General Assembly, and codified as
Chapter 25 of Title 21 of the Vermont Statutes Annotated. Specific
authorization for this rule is codified as
21 V.S.A.
§
2003(c).
Section II Application
These rules are applicable to all employers (as that term is
defined in Section III.3 below) having more than eight full-time equivalent
employees. As of July 1, 2008, these rules will be applicable to all employers
having more than six full-time equivalent employees. As of July 1, 2009, these
rules will be applicable to all employers having more than four full-time
equivalent employees.
IMPORTANT NOTE: The employer's health care premium contribution
is intended to provide a partial source of funding for the Catamount Health
plan. The payment of a premium contribution on behalf of an uncovered employee
does not necessarily entitle that uncovered employee to enrollment in the
Catamount Health plan. Enrollment in the Catamount Health plan is the
responsibility of the individual, and is subject to income caps and additional
individual contributions.
Section
III Definitions
1. Commissioner:
The Vermont Commissioner of Labor.
2. Employee: Any individual, 18 years of age
or older for all of a calendar quarter, employed full-time or part-time by an
employer to perform services in this state, when such services fall under the
definition of employment as that term is defined by section
1301(6)
of Title 21 of the Vermont Statutes Annotated. It is the intent of this rule
that employees used by an employer for purposes of the employer's health care
premium contribution calculation will be substantially the same as the
employees reported by an employer for purposes of complying with Vermont
unemployment compensation law.
a) Sole
Proprietors are not considered employees.
b) Limited Liability Companies (LLCs) with a
single member or manager are not considered employees.
c) LLCs with more than one member or manager
are not considered employees if they elect partnership status for federal tax
purposes.
d) LLCs electing
corporate status for federal tax purposes are considered employees.
3. Employer: Any person who is
required under subchapter 4 of chapter 151 of Title 32 of the Vermont Statutes
Annotated to withhold income taxes from payments of income with respect to
services, but shall not include the United States government.
4. Full-time equivalent (FTE): The number of
employees expressed as the number of employee hours worked during a calendar
quarter divided by 520. The FTE calculation is based on a 40-hour workweek. No
more than one FTE may be assessed against an individual employee, regardless of
the actual number of hours worked by that employee.
For the purpose of calculating FTEs, the phrase "hours worked
during a calendar quarter" means hours worked during all pay periods in that
quarter for which gross wages were reported as paid.
5. Uncovered Employee:
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 as defined by the health care plan offered by the employer;
or
c) An employee who is offered
and is eligible for coverage by the employer but elects not to accept the
coverage and has no other health care coverage under either a private or public
plan.
i. An employee who has health care
coverage during any portion of a calendar quarter shall not be considered an
uncovered employee for purposes of that quarter's premium
contribution.
ii. An employee who
has enrolled in a health care coverage plan, but is not actually covered under
such plan until a subsequent effective date of coverage, shall not be
considered an uncovered employee, provided such intervening period is no longer
than six months.
6. Health Care Coverage: Catamount Health
Care, Medicare, Medicaid, the Vermont health access plan (VHAP), Dr. Dynasaur,
or private insurance or employer-sponsored coverage that includes both hospital
and physician services.
Section
IV Method of Calculating and Reporting Hours Worked by Uncovered
Employees
1. Employers must report, on a
quarterly basis, the total number of hours worked by each uncovered employee,
as that term is defined in Section III. Reporting will be accomplished by means
of Department of Labor Form C-101, the same form used by employers to report
wage information for purposes of complying with Vermont's unemployment
compensation law. Form C-101 has been modified to accommodate reporting wage
information necessary for both health care premium contributions and
unemployment compensation assessments.
2. Employers must file Form C-101 on or
before the last day of the month following the end of the quarter.
3. Quarterly health care premium
contributions are calculated in the following manner:
a) Add the total hours worked by all
uncovered employees during the quarter.
i) For
each salaried employee, use 520 hours a quarter;
ii) For each employee who worked in excess of
520 hours in the quarter, use 520 hours a quarter.
b) Divide the resulting number by 520
(representing one FTE, or full-time equivalent), and round down to the nearest
whole number.
c) Subtract 8 (as of
July 1, 2008 subtract 6; as of July 1, 2009 subtract 4).
d) Multiply the resulting number by the
quarterly health care premium contribution, currently established as $ 91.25.
Starting in fiscal year 2009, this number will be adjusted annually by a
percentage equal to any percentage change in premiums for Catamount Health for
that fiscal year. The commissioner will notify employers of the new number
annually.
4. A
worksheet, attached to these rules as Appendix A, can be used to help calculate
the total quarterly premium contribution. An online calculator is available at
the Department of Labor's website. (insert URL once it is up)
Section V Record Keeping
Requirement
On an annual basis, an employer who offers health care coverage
must obtain, from each person in his or her employ who declines the employer's
health care coverage, a declaration of health care coverage. Such declaration
shall be on a form, document or secure electronic statement provided to each
employee by the employer, and shall require each employee to state whether or
not the employee has health care coverage. In the event the employee has health
care coverage, the employee shall affirmatively acknowledge the existence of
such coverage.
Declarations of coverage and records of reported uncovered
employees shall be maintained in such a manner as required by law, and as to be
reasonably available for review or audit by the commissioner, and shall be
maintained for a minimum of four years.
Section VI Employee Leasing Companies
In an employee leasing agreement between an employee leasing
company and a client company, as those terms are defined in section
1031 of
Title 21 of the Vermont Statutes Annotated, leased employees shall be
considered employees of the client company for purposes of complying with the
provisions of this rule.
Section
VII Penalties and Interest
1.
Failure to file a timely quarterly report, or failure to accurately report all
hours worked by uncovered employees, shall subject an employer to a penalty
consistent with section
1328
of Title 21 of the Vermont Statutes Annotated.
2. Failure to make timely payment of all
health care premium contributions due shall subject an employer to the interest
rates and collection methods set forth in section
1329
of Title 21 of the Vermont Statutes Annotated.
21 V.S.A.
§
2003
