Employers Must Provide Notices to Employees on Health Care Coverage Options

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The Health Insurance Marketplace is supposed to provide a competitive private health insurance market where individuals and employees of small businesses can shop for affordable coverage.

The Affordable Care Act (also called the Health Care Act) will expand access to affordable health coverage. To do this, the government is creating insurance exchanges, referred to as the Health Insurance Marketplace.

Health Insurance Marketplace

The Marketplace is supposed to provide a competitive private health insurance market where individuals and employees of small businesses can shop for affordable coverage. Some Marketplaces will be run by the state, others by the federal government or a combination of the two. They are currently being set up and are supposed to be up and running by Oct. 1, 2013.

Open enrollment for health insurance coverage through the Marketplace begins Oct. 1 for coverage beginning Jan. 1, 2014. Individuals who don’t have insurance coverage after 2013 may pay a penalty.

Employee Notices

To make sure employees have the information they need to access the Marketplace, beginning Oct. 1, employers must provide their employees written notice of the health coverage it may offer along with an explanation of the new Marketplace coverage options.

Note: Although the President’s administration recently announced a one-year delay of the mandate for employers to offer health insurance coverage or face penalties, the delay does not affect the requirement for employers to provide notices to these employees.

Employers Subject to the Notice Requirement

Most employers will be subject to this requirement as it applies to those covered by the Fair Labor Standards Act (FLSA). In general, the FLSA applies to employers that have one or more employees who are engaged in commerce and gross annual sales of $500,000 or more.

Providing Notice to Employees

The notice must be provided to all employees, regardless of plan enrollment status or of part-time or full-time status. A separate notice does not need to be given to dependents or other individuals who are or may become eligible for coverage under the plan, but who are not employees.

Content of the Notice

The notice must include specific information. The Department of Labor (DOL) has provided two model notices (one for employers offering insurance coverage, the other for employers not offering coverage) that may be used.

Timing and Delivery of the Notice

The notice must be provided in writing by first-class mail or, if certain requirements are met, it can be delivered electronically. It must be provided by Oct. 1 to employees hired before that date. Employees hired after Sept. 30 must be given the notice at the time of hiring.

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