It’s notice season! As an employer, you may have received a letter regarding the health care coverage of one or more of your employees. Could this notice lead to penalties from the ACA? Perhaps. Check out our tip sheet to know what to do when that unexpected mail arrives.
The 5W’s
WHO: The FFM
The Federally Facilitated Marketplace may be the one sending you notices regarding your employees.
WHAT: The FFM’s Exchange Notice Program
The Marketplace is required to send employers notices, which can inform them of their employees’ advanced subsidies, inquire about an employee’s full-time status, and potential tax liability information. To view a full sample letter, sent through the Federally Facilitated Marketplace (FFM), click here.
Said letter may etch out that you as an employer offered health care beyond the means of your employee (or didn’t offer any coverage at all), leading to their receipt of a Premium Tax Credit.
WHY: To Avoid Penalties
Should it be deemed that your health care offering was unaffordable (or nonexistent), you may be penalized by way of an Employer Shared Responsibility Payment. Fear not, this can be appealed.
WHEN: 90 Days To Appeal
You as an employer have 90 days from the date of the notice to appeal. If you have received a notice and feel that the tax liability is not yours, an appeal may be necessary.
WHERE: The FFM, the IRS, and an ESQ.
It’s best to contact the IRS immediately upon receipt of a notice with any questions or concerns. Should you file an appeal, you must provide the FFM with documented proof that you provided your employee with an offering of minimum essential coverage. If you are still filing your 1094 and 1095 forms electronically, you have until June 30th, but copies of those forms are necessary in your appeal. It is best to not communicate with your employee regarding this notice, as the rules surrounding the ACA’s stance on anti-retaliation could worsen the situation. Contact your lawyer for any next steps.
