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Exchange Notice May Be Distributed On Behalf Of Employers

An entity other than the sponsoring employer of a group health plan, such as an insurer, union, or third-party administrator, may send the ?Ç£Notice of Coverage Options?Ç¥ (aka ?Ç£Exchange Notice?Ç¥) on behalf of the employer under the Affordable Care Act.?á This notice must be distributed to all employees by October 1, 2013.?á If such other entity is providing the notice only to plan participants, the employer is still obligated to ensure that all employees who are not enrolled in the plan also receive the notice. The relevant U.S. Department of Labor FAQs can be found?áhere.

Final Rules Permitting Employers to Appeal Exchange Decisions

An exchange will notify an employer when it finds an employee is eligible for a premium tax credit or cost-sharing reduction in connection with coverage purchased through the exchange. This notice will identify the employee, state that the employee has been found eligible for such government assistance, state that the employer may be liable for the employer shared responsibility penalty, and notify the employer of its right to appeal this determination. ?áThe employer will then have 90 days to appeal the exchange?ÇÖs determination that the employer does not provide such employee with health coverage that qualifies under the Affordable Care Act. The final rules can be found here.

September 2013
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