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  • Andy Adams

First ACA Health Insurance Marketplace Letters Received...

We are hearing reports that the first letters from the Department of Health and Human Services regarding employees who have obtained premium subsidies through the Health Insurance marketplace have been received.

This is important because this is going to be your first indication that you may or may not owe a penalty because of the purchase of health insurance with a subsidy by an employee. You will receive this notice if you are an applicable large employer (with greater than 50 employees) and you (1) do not offer health insurance; (2) do not offer affordable health insurance or health insurance that fails the minimal value test. We have attached a redacted letter received by a customer this past week for your review.

This notice WILL NOT give you an amount to pay. It is not a penalty notice. However, IT IS an early indicator. If you receive one, and you are not anticipating owing any penalty for the above reasons, you should follow the appeals process. You have 90 days from the date of the letter to file the appeal. Please note we are already seeing letters referencing employees who were never employed by the employer. The error rate on these is going to be high!

Note also that this is a notice for 2016 ONLY. From some reason, we seemed to have skipped 2015.

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