Starting in 2016, the Federal Health Insurance Marketplace (the “Marketplace”) will send notices to applicable large employers whose employees received advance premium tax credits and cost-sharing reductions, if those employees claimed that they were neither enrolled in nor eligible for employer-sponsored group health plan coverage that is affordable and meets the minimum value requirement under the Patient Protection and Affordable Care Act. Such notices are currently in the process of being sent following the close of open enrollment for the 2016 coverage year, and they will continue to be sent periodically throughout the remainder of 2016. This year, a notice will be sent only if an employee included his or her employer’s mailing address on his or her application for Marketplace coverage. However, in the future, the Marketplace will consider alternative ways of contacting employers.
If you are an applicable large employer and receive such a notice, you may appeal it and provide evidence that you do provide access to affordable group health coverage that provides minimum value and/or that the identified employee is enrolled in your group health coverage and therefore ineligible for an advance premium tax credit or cost-sharing reduction from the Marketplace. You will have 90 days from the date of the notice to request such an appeal. If you receive a notice from the Marketplace and would like assistance in the appeal process, please let us know and we can provide you with more information and assistance.