On Oct. 1, 2013, the new health insurance Marketplaces created by the Affordable Care Act (ACA) will take effect after three years of development.
At that time, as part of ACA provisions, employers must inform employees with a written notice about the Marketplace.
Who gets notified?
Most employees will receive this notice, with limited exceptions for certain public employees, agricultural workers and volunteers.
Employees must be notified even if they already have health insurance, and both full-time and part-time employees must be notified.
Current employees must be given the notice by Oct. 1 at the latest. New employees hired after Oct. 1 must be given the notice within two weeks of their date of hire.
What’s in the notice?
The notice must include the following information:
- Information about what the Marketplace is, as well as contact information and a description of services provided by the Marketplace.
- A statement that you may be eligible for a premium tax credit to help you with premium costs if you purchase coverage through the Marketplace.
- A statement informing you that if you receive coverage through a Marketplace plan, you may lose any employer contributions to your health benefits, and that those contributions are often excluded from income for tax purposes, while Marketplace coverage payments are made on an after-tax basis.
The notice may include information about your health plan if your employer offers one. This information can help clarify whether you will actually be eligible for Marketplace subsidies or tax credits, because eligibility depends on whether your employer’s plan meets certain standards related to coverage and affordability.
What if I am eligible for COBRA coverage?
If you lose coverage under your employer’s plan, you and your family members may be eligible to continue your health plan coverage through COBRA.
Individuals who are eligible for COBRA coverage must receive a notice from the health plan administrator describing their right to continue coverage and how to make an election. This notice may also include information on coverage options available through the Marketplace.
Some COBRA recipients may want to compare their COBRA coverage with alternatives to COBRA coverage that are available through the Marketplace. COBRA recipients may also be eligible for a premium tax credit for a Marketplace plan.