After a brief delay, the Department of Labor has issued additional guidance and model notices on another of the many employer reporting requirements instituted by the Patient Protection and Affordable Care Act. This requirement, under Section 18B of the Fair Labor Standards Act, added by Section 1512 of PPACA, requires employers to notify their employees of the coverage options available through the new Health Insurance Marketplaces, previously called Health Insurance .
On January 24, the DOL delayed this requirement, initially set to become effective March 1, 2013. The new effective date is now October 1, 2013 – just in time for the grand opening of the Health Insurance Marketplaces. All employers subject to the FLSA are required to provide this notice to all current employees no later than October 1, 2013, and to new employees hired on or after that date. This notice must be distributed to all employees, regardless of enrollment status in the employer’s health plan (if applicable) or classification as a full time or part time employee.
The DOL has issued two model notices: one for employers who offer a group health plan, and one for employers who do not offer a group health plan.
DOL Technical Release 2013-02 lists the following content requirements for the notice:
- Informing the employee of the existence of the Marketplace (referred to in the statute as the Exchange) including a description of the services provided by the Marketplace, and the manner in which the employee may contact the Marketplace to request assistance;
- If the employer plan’s share of the total allowed costs of benefits provided under the plan is less than 60 percent of such costs, that the employee may be eligible for a premium tax credit under section 36B of the Internal Revenue Code (the Code) if the employee purchases a qualified health plan through the Marketplace; and
- If the employee purchases a qualified health plan through the Marketplace, the employee may lose the employer contribution (if any) to any health benefits plan offered by the employer and that all or a portion of such contribution may be excludable from income for Federal income tax purposes.
Employers are required to complete a portion of each notice. As expected, the notice required of an employer that offers coverage to some or all of its employees contains more information to be provided by the employer. Employers are asked to describe if the employee receiving the notice is eligible for employer sponsored group health plan coverage, and if so, how much the self-only premium costs the employee and whether the employer sponsored coverage meets the minimum value requirement. Employers with different classes of eligibility may need to pre-fill multiple versions of the form to account for variations in eligibility among employees. Employers should work to make these determinations well in advance of the October 1, 2013 deadline.
For more information, see DOL Technical Release 2013-02.
