GSA Healthcare Reform Series: Health Insurance Marketplace (aka Exchange) Notice

As the details surrounding all things healthcare reform continue to evolve, please feel free to share your thoughts and/or questions in the comments section of this blog below.

Health Insurance Marketplace Notice

One of the upcoming Affordable Care Act (ACA) action items is the preparation and distribution of a notice to employees about the health insurance exchanges that will become available to individuals starting on January 1, 2014. All employers, including those who do not sponsor a group health plan, must provide a form of the notice to its employees. In addition, all employees must be provided the notice, including those who may not be eligible for employer-sponsored group health plan coverage.

These notices were originally required to be distributed by March 1, 2013. However, the Department of Labor (DOL) delayed this distribution requirement until it had an opportunity to issue further guidance. The DOL has now issued its guidance, and has provided a model notice to be used by employers to comply with their notice obligations. The DOL has issued two model notices: one for employers who do not offer any group health plan coverage, and a second for employers who do offer coverage to some or all of its employees. The guidance issued by the DOL, and the notices, refer to the insurance exchanges as "Marketplaces."

Notices provided by the DOL for employers who offer group health plan coverage can be downloaded here, http://www.dol.gov/ebsa/pdf/FLSAwithplans.pdf.

Guidance for these notices can be found on the DOL website, http://www.dol.gov/ebsa/newsroom/tr13-02.html.

Key aspects of the Market Notice:

  1. Who Must Receive the Marketplace Notice?
    • Employees: All employees must receive the Marketplace Notice, regardless of whether they are eligible to participate in the health plan (such as part-time employees) and regardless of whether they are enrolled in the plan.
    • Dependents: Separate Marketplace Notices are not required to be sent to spouses or dependent children.
    • Former Employees: Marketplace Notices are not required to be sent to former employees, regardless of whether they are still covered by or are eligible for coverage under the plan (e.g., pursuant to COBRA or retiree coverage).
  2. When Must the Marketplace Notice Be Delivered?
    • Current Employees: Employees who are on the payroll on or before September 30, 2013 must receive the notice by October 1, 2013.
    • New Employees: New employees hired on or after October 1, 2013 must be provided with a copy of the Marketplace Notice within 14 days of the date of hire. This 14-day period rule is in effect from October 1, 2013 through December 31, 2014. The DOL may modify this in the future.
  3. How to Deliver the Marketplace Notice?
    • Mail: The Marketplace Notice may sent via first-class mail.
    • Electronic Delivery: The DOL electronic delivery standards will apply to the Marketplace Notices. Therefore, the Marketplace Notices may be delivered by e-mail to those employees whose work-site access to e-mail is an integral part of the employee's job duties.
    • New Hire Package The DOL guidance does not expressly state that the Marketplace Notice may be included in a new hire package. But presumably, that would be an acceptable method of delivery for new hires.
  4. Required Content of the Marketplace Notice
    As acknowledged in the Department of Labor guidance, the Marketplace Notice is only required to disclose the following:
    • The existence of the Marketplace;
    • A description of services provided by the Marketplace;
    • Contact information for the Marketplace;
    • A statement that the employee may be eligible for a premium tax credit if the employee purchases a qualified health plan through the Marketplace; and
    • A statement that if the employee purchases health coverage through the Marketplace, the employee may lose the contributions made by the employer (if any) toward coverage offered through the employer's plan, and that all or a portion of the contributions may be excluded from the employee's income for Federal income tax purposes.

The guidance from the DOL acknowledges that the model is just that - a model, and that employers may use a modified version, provided that it meets the contents requirements set forth above. If you have questions regarding the Marketplace/Insurance Exchange requirements, call 1.800.250.2741 or email us at solutions@gsanational.com to contact one of our Healthcare Reform subject matter specialists.


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