Navigate the Employer Mandate with Enhanced Flyer

Employers can use a newly enhanced flyer to help determine if they are complying with the Employer Mandate or whether they may face penalties. The flyer, which provides an at-a-glance look at the Employer Mandate, displays an easy-to follow graphic illustration of the requirements along with a glossary of terms.

For more detailed information about the Employer Mandate, including specifics about when the rules apply, how to determine full-time employees, penalties, and more, view the Employer Mandate: Guide. This guide also includes an example using a fictional company to help illustrate the steps an employer must take to determine its obligation under the Employer Mandate.

New FAQs Released

Federal agencies have released a new set of commonly asked questions and answers about Affordable Care Act implementation, which address coverage of preventive services, mental health benefits and women’s cancer benefits.

The links from the bullets below provide summarized answers to questions contained in the original document. For complete answers to the questions and to read the original document, follow this link.

• Coverage of preventive services
• Mental Health Parity and Addiction Equity Act
• Women’s Health and Cancer Rights Act

Source: FAQs about Affordable Care Act Implementation (Part 31); published April 20, 2016

 

 

 

 

New Marketplace Notice

The Health Insurance Marketplace is beginning to send a new notice to certain employers regarding the Affordable Care Act’s employer mandate¹. The notice is sent because an employee:

• enrolled in a qualified health plan on the Marketplace for 2016;
• was determined eligible for advance payments of the premium tax credit or cost-share subsidies for at least one month during 2016 to help pay for Marketplace coverage; and
• indicated that:
  • his or her employer did not offer employer-sponsored health coverage;
  • did have an offer of health coverage, but it was not affordable or did not provide minimum value; or
  • was in a waiting period and unable to enroll in health coverage.

Next steps
According to the Marketplace:

• Employers may file an appeal within 90 days of the date of the letter if they believe there has been a mistake regarding the employee’s eligibility for premium tax credits or cost-share subsidies.
• Filing an appeal could also eliminate reports from the Marketplace to the IRS that employees received premium tax credits or cost-share subsidies following an appeal decision in an employer’s favor.

However, filing an appeal won’t necessarily affect whether employers have to pay an employer mandate penalty to the IRS, because the IRS will determine independently whether employers face penalties. For more information, visit IRS.gov/aca or call the IRS at 800.829.4933 Monday through Friday from 7 a.m. to 7 p.m. (local time).

For employers that file appeals, the Marketplace will consider evidence provided by both the employer and employee to determine if the employee is eligible for premium tax credits or cost-share subsidies.

Follow this link for a sample notice.
¹ACA’s Shared Responsibility for Employers Regarding Health Coverage Rule

ACA Employer Mandate Webinar

An Internal Revenue Service webinar about the ACA employer mandate has been archived and is available for viewing.

View “ACA: Employer Shared Responsibility,” which aired on April 6, 2016, by visiting the IRS Video Portal.