CLIENT ALERT: ACA Marketplace Notices for Employers Begin This Year

marketplace notices for employersIn 2016, employers will begin receiving notices about employees enrolled in the Health Insurance Marketplace that was introduced with the Affordable Care Act (ACA).
Notices will be sent to employers via mail from the Federally-Facilitated Marketplace (FFM).

If I Receive a Notice, What Does That Mean?

  • If you receive a notice from the FFM, you have at least one employee who received advanced premium tax credits for Health Insurance Marketplace coverage for at least one month in 2016.  That employee listed your business and address as their employer.
  • As applicable large employers are typically required under the ACA to provide affordable health insurance to their employees, receipt of this notice may mean your business has a tax liability under the Employer Shared Responsibility Payment mandate.
  • The notice itself does not determine if your business owes the Employer Shared Responsibility Payment, but is an indication that you might be liable. The IRS will determine which employers are subject to tax liability.
What Should My Business Do If We Receive a Notice?
  • If you receive a notice from the FFM you should determine if your business has a tax liability for this employee’s marketplace coverage.
    • Questions to ask include:
      • Is my business considered an applicable large employer and subject to ACA health insurance mandates?
        • If so, does our health coverage comply with ACA requirements?
      • Is this employee full time?
      • Is the employee also enrolled in our health coverage?
  • If you determine you would like to appeal the notice, your business has 90 days from the date of notice to request an appeal from the Marketplace.
According to the Center for Consumer Information and Insurance Oversight (CCIIO), a division of Centers for Medicare & Medicaid Services (CMS), and the “employer notice” program will be phased in during 2016 with plans to expand and improve the notice program moving forward.
We hope this information has been helpful to you.  If you receive a marketplace notice and have questions about your tax liability, please contact your Whalen & Company representative.