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Model Exchange Notice for Employers Released By DOL

May 15 - Posted at 2:01 PM Tagged: , , , , , , , , , , , ,

A provision of Health Care Reform requires employers to provide a notice to all employees regarding the availability of health coverage options through the state-based exchanges. The Department of Labor delayed the original requirement that the notice be distributed by March 1, 2013, as it was determined that there was not enough information regarding exchange availability.

 

 

The DOL recently issued temporary guidance along with a model notice. The DOL has issued the model notice early so employers can begin informing their employees now about the upcoming coverage options through the marketplace.

 

 

Two model notices were released by the DOL. One is for employers who currently offer medical coverage and the other is for those who do not offer medical coverage.

  

 

Employers are required to issue the exchange coverage notice no later than October 1, 2013. This will coincide with the beginning of the open enrollment period for the marketplace.

 

The notice must be provided to all employees, regardless of their enrollment on the group health plan. It must be provided to both full time and part time employees as well. Employers are not required to provide a separate notice to dependents. Employers will need to provide the notice to each new employee (regardless of their status) who are hired on or after October 1, 2013 within 14 days of their hire.

 

 

An exchange coverage notice must include –

 

  • information about the existence of the exchange, including a description of the services provided by the exchange and how to contact the exchange;

 

  • a statement that the employee may be eligible for subsidized exchange coverage (i.e., premium tax credit under Internal Revenue Code § 36B), if the employee obtains coverage through the exchange and the employer’s plan fails to meet a 60% minimum value; and

 

  • a statement that the employee may lose the employer contribution (if any) toward the cost of employer coverage (all or a portion of which may be excludable from income for Federal income tax purposes) if the employee obtains coverage through the exchange.

 

The DOL also modified its model COBRA election notice to include information about the availability of exchange coverage options and eliminate certain obsolete language in the earlier model.

 

 

Please contact our office for a copy of the model notice(s).

Our topic this month covers the Final Rule from HHS and the Exchanges.

 

Areas discussed include:

 

  • Changes to Preventative Services including OTC medications, immunizations, and FDA approved contraceptive methods

 

  • Pay or Play Rule and how to avoid the Pay or Play Rule penalties

 

  • Penalties Based on Subsidy Eligibility

 

  • Health Insurance Exchange

 

  • Small Business Health Options Program (SHOP)

 

 

Contact us today for more information on this topic.

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