Posted on September 25, 2013

Health Insurance Marketplace Notices: Frequently Asked Questions

Under the Patient Protection and Affordable Care Act (PPACA), all employers who are subject to FLSA must issue a notice to all employees by October 1, 2013, providing information about the new public health insurance marketplaces (formerly called exchanges). The Department of Labor has provided model notices that employers can use to satisfy this requirement. Here are some frequently asked questions about the marketplace notices:

1. To whom must the marketplace notices be distributed?

Employers must provide a marketplace notice to each employee, regardless of plan eligibility or enrollment status, part-time or full-time status, or status as a regular, temporary or seasonal employee. Employers are not required to provide separate notices to dependents or other individuals who are or may become eligible for coverage under the plan but who are not employees, such as independent contractors, retirees, partners, etc.

2. When do I have to distribute the marketplace notice?

Employers are required to provide the marketplace notice to each employee by October 1, 2013. For employees hired after that date, the employer must provide the notice within 14 days of the employee’s start date. After October 1, 2013, experts believe employers will include the notice in new hire packets.

3. There are multiple model marketplace notices, so which notice do I use?

*There is one model notice for employers who do not offer a health plan, available here This includes instances where the only health plan available to its employees is offered by a union, even though the employer makes contributions on behalf of the employees.

*There is another model for employers who offer a health plan to some or all employees, available here This means that even if you offer benefits to only a certain class of employees, you would still use this model notice.

4. What name, EIN, telephone number and address do I use if my organization is part of a controlled group of businesses?

Sections 3 through 9 of the model notice require information about the employer. Since distributing the notice is an employer obligation, not an ERISA plan obligation, each employer within a controlled group of companies is required to distribute the notice to its own employees under its own name, EIN, telephone number and address. The contact information contained in sections 10 through 12 of the model notice may be different and may relate to whoever can answer questions about employee health coverage, such as the plan sponsor.

5. Should I complete the optional sections 13 through 16 on page 3 of the model notice?

Sections 13 through 16 of the model notice provide additional information to employees to assist them should they decide to buy health insurance coverage through a marketplace. Completing these sections is optional, so employers may choose not to provide this information. Employers choosing to not complete this section should remove the last sentence on the prior page, which states: “Here’s the employer information you’ll enter when you visit HealthCare.gov to find out if you can get a tax credit to lower your monthly premiums.”

6. What are the penalties for not distributing the marketplace notice?

As of the date of this publication, there are no penalties described by the government for failure to provide the marketplace notice to employees. It is possible that, if an employer fails to supply the notice and, as a result, an employee fails to take advantage of marketplace-based coverage, the employee might seek redress from the employer. In any case, providing these notices can only help your employees feel more informed about the changing health care landscape.

Learn more about the marketplace notices at the Department of Labor website.


Source: Jeff Lowry, ERISA Attorney