Under the ACA the health insurance Marketplace (also called health exchanges) were set up to facilitate the purchase of health insurance in each state. Each Marketplace provides a set of government-regulated and standardized health care plans from which individuals may purchase health insurance policies eligible for federal subsidies. All health insurance exchanges were to be fully operational by January 1, 2014.
Exchanges may be established either by the state itself as a "state exchange" or by the Secretary of Health and Human Services (HHS) as a "federally-facilitated exchange." A federally-facilitated exchange may be operated solely by the federal government, or it may be operated by the federal government in conjunction with the state, as a "partnership" exchange. As a result, the authority and responsibilities of an exchange will vary by state. Qualified individuals and small businesses will be able to purchase private health insurance through exchanges.
While the fundamental purpose of the Marketplace will be to facilitate the offer and purchase of health insurance, nothing in the law prohibits qualified individuals, qualified employers, and insurance carriers from participating in the health insurance market outside of exchanges. Moreover, ACA explicitly states that enrollment in exchanges is voluntary and no individual may be compelled to enroll in exchange coverage.
Enrollment in the health insurance Marketplace takes place once a year during an open enrollment period. If individuals miss this enrollment opportunity, he or she can still enroll as a special enrollee due to certain life events.
In general, health plans offered through exchanges will provide comprehensive coverage and meet all applicable private market reforms specified in ACA. Most exchange plans will provide coverage for "essential health benefits" at a minimum; be subject to certain limits on cost-sharing, including out-of-pocket costs; and meet one of four levels of plan generosity based on actuarial value (Bronze, Silver, Gold, and Platinum).
To make exchange coverage more affordable, certain individuals will receive premium assistance in the form of federal tax credits. Employees can find more information about the Marketplace at www.healthcare.gov.
Under the ACA, employers covered by theFair Labor Standards Act (FLSA)* are required to provide a notice to employees about the Marketplace.
The DOL has created two separate notices that are to be used. The first notice is to be used by employers that offer an employer-sponsored health plan. The second notice is to be used by employers that do NOT offer an employer-sponsored health plan.
Up-to-date notices can be found at:
Employers are required to provide the notice to each new employee within 14 days of the employee’s start date. The notice is required to be provided automatically, free of charge to each employee, regardless of plan-enrollment status, part-time status or full-time status.
Employers are not required to provide a separate notice to dependents or other individuals 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 harborare met.
There is no requirement to obtain an employee’s signature; however, an employer may want to track delivery and receipt of the notice.