Under the Affordable Care Act (ACA) each state was required to create and maintain a health insurance exchange by Jan. 1, 2014. Health insurance exchanges will serve as a health insurance marketplace where individuals and small businesses may purchase health plans if there is no employer-sponsored health plan or if the employer-sponsored health plan is unaffordable or fails to offer essential health benefits. 

Employers covered by the Fair Labor Standards Act (FLSA)* are required to provide a notice to employees about the state’s health insurance exchanges. 

*In general, the FLSA applies to employers that employ one or more employees who are engaged in, or produce goods for, interstate commerce. This broad definition will likely encompass most employers.

There is one model for employers who do not offer a health plan and another model for employers who offer a health plan to some or all employees. Employers may use one of these models, as applicable, or a modified version, provided the notice meets the content requirements described below.

To view the Official DOL Marketplace Notice go to http://www.dol.gov/ebsa/healthreform/regulations/coverageoptionsnotice.html.

Distribution of Notice

Employers are required to provide the notice to each new employee at the time of hiring beginning October 1, 2013. 
The Department will consider a notice to be provided at the time of hiring if the notice is provided within 14 days of an employee’s start date.

The notice is required to be provided automatically, free of charge to each employee, regardless of plan-enrollment status or part-time or full-time status. Employers are not required to provide a separate notice to dependents or other individuals who are or may become eligible for coverage under the plan but who are not employees.

The notice must be provided in writing in a manner calculated to be understood by the average employee. It may be provided by first-class mail. Alternatively, it may be provided electronically if the requirements of the Department of Labor’s electronic disclosure safe harbor are met.

There is no requirement to obtain an employee’s signature; however, an employer may want to track delivery and receipt of the notice.

Content Requirements

The notice must inform employees of the following:

•    The existence of the government-run health care exchanges/the Marketplace, including a description of the services provided and the manner in which employees may contact an exchange 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, employees may be eligible for a premium tax credit under section 36B of the Internal Revenue Code if they purchase a qualified health plan through an exchange.
•    If employees purchase a qualified health plan through an exchange, they may lose the employer contribution (if any) to any health benefits plan the employer offers. All or a portion of this contribution may be excluded from income for federal income tax purposes.

Completing Exchange Notice Fields

Employers who offer health plans

•    Page #1:

  • Insert contact information for employee to obtain more information about coverage

•    Page #2:

  • Fill out PART B: Information About Health Coverage Offered by Your Employer.
  • Fill out eligibility information for employees and fill out eligibility information for dependents.
  • Check the last box if your plan meets the minimum value standard. (A plan does not provide minimum value if the plan’s share of total allowed costs of benefits provided under the plan is less than 60 percent of such costs.)*

•    Page #3: (THIS PAGE IS OPTIONAL)

  • Complete question #13.
  • Complete question #14. (A plan does not provide minimum value if the plan’s share of total allowed costs of benefits provided under the plan is less than 60 percent of such costs.)
  • Complete question #15 with plan premiums if the plan meets the minimum value standard.
  • Complete question #16 if the current plan year is ending “soon” and plan changes will be made.

Employers who do not offer health plans

•    Page #2:

  • Fill out PART B: Information About Health Coverage Offered by Your Employer

Questions

For questions on any of this or assistance with filling out this notice, please contact your Account Manager.