In addition to an upcoming national election, we are now quickly approaching open enrollment season for the Affordable Care Act. This is the time of year when people can apply for healthcare coverage through the exchanges and look for income-based subsidies to help them offset some of their insurance costs.
It’s also the time when employees who don’t feel they have an adequate or affordable employer-sponsored health plan may seek out coverage and subsidies through the exchanges. While an employer may be tempted to find relief in one less person to cover (and pay for), there may be some repercussions.
According to a recent article in the National Law Review, employers are starting to receive notices that:
- An employee has been determined to be eligible for premium tax credits or cost-sharing reductions to help pay for Marketplace coverage and has enrolled in Marketplace coverage
- The employer may have to pay an employer shared responsibility payment (i.e., a penalty) to the Internal Revenue Service (IRS)
- The employer has the right to appeal the determination
These notices are typically addressed to the “Benefits Manager” and require action on their part. An employer may appeal by completing and submitting the Employer Appeal Request Form available at www.healthcare.gov or by sending a letter that includes the information requested on the form. The employer can then designate a secondary contact (i.e. an attorney) as the employer’s representative when dealing with the appeal.
In 2016, only employers that fall into the 50-plus employee range (Applicable Large Employer or ALE) are subject to the penalties.
Partner with a PEO to Avoid ACA Ramifications
If you have received one of these and are confused and concerned about the ramifications, it appears you have reason to be. Employer shared responsibility penalties can be substantial if it is determined that an employee is eligible under the ACA. If you are an ALE or on the threshold of becoming one, you should consult with your attorney or explore other options.
One of those other options would be to consider working with a Professional Employer Organization like GMS. Contact us today and let our HR experts help you clear your ACA anxiety, by assuring you are compliant with all guidelines.