Marketplace Subsidy Notices: What Employers Need to Know

In late June, the U.S. Department of Health and Human Services (HHS) reportedly mailed out several hundred thousand notices to employers, dated June 21, 2016, informing them that one or more of their employees have been certified as eligible for a premium subsidy through a federal Health Insurance Marketplace. Employers in states with state-run Marketplaces may have received
similar notices since 2015; however, HHS has just begun sending notices from the federal Marketplaces this June. A list of states and whether their Marketplace is state-based or federally-facilitated can be found here.

The notice informs the employer that the individual indicated that he or she worked for the employer and either: (i) didn’t have an offer of health care coverage from the employer; (ii) did have an offer of health care coverage, but it wasn’t affordable or did not provide minimum value; or (iii) was in a waiting period and unable to enroll in health care coverage. This alert describes the appeal process and provides recommendations for employers who have received a notice and are considering whether to appeal.

Read the full legislative update.