Employee Coverage Options Through the Marketplace

Posted by BAS - 05 October, 2023

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For HR professionals, keeping up with evolving healthcare regulations is paramount. Section 18B of the Fair Labor Standards Act (FLSA), introduced by the Affordable Care Act (ACA), brings a set of obligations that HR departments must understand. This article will clarify the requirements outlined in Section 18B.

Understanding ACA Section 18B

ACA Section 18B dictates that applicable employers must furnish employees with written notices about the availability of healthcare coverage options through the Health Insurance Exchanges, also known as Marketplaces. These notices serve to inform employees about their healthcare choices and potential tax credits they may qualify for under the ACA.

Key Components of the Notice

The notice must include the following information:

  • Exchange Description: A clear explanation of the services provided by the Exchanges and how employees can contact them for assistance.
  • Premium Tax Credit Eligibility: If the employer's healthcare plan contributes less than 60 percent of the total allowable costs, employees should be informed that they may be eligible for a premium tax credit under section 36B of the Internal Revenue Code if they purchase a qualified health plan through an Exchange.
  • Impact on Employer Contributions: Employees purchasing a qualified health plan through an Exchange should be aware that they may lose their employer's contribution (if any) to the company's health benefits plan. Additionally, a portion of this contribution may be excludable from federal income tax.

Compliance

The Department of Labor has a sample document employers may use to satisfy the notification requirements. That document may be accessed by clicking here.

Complying with ACA Section 18B is essential for HR professionals to ensure employees receive vital information about their healthcare options through the Marketplace. By distributing the required notice, HR departments can navigate this regulatory landscape effectively, ensuring employees have access to the healthcare information they need.


Benefit Allocation Systems (BAS) provides best-in class, online solutions for: Employee Benefits Enrollment; COBRA; Flexible Spending Accounts (FSAs); Health Reimbursement Accounts (HRAs); Leave of Absence Premium Billing (LOA); Affordable Care Act Record Keeping, Compliance & IRS Reporting (ACA); Group Insurance Premium Billing; Property & Casualty Premium Billing; and Payroll Integration.

MyEnroll360 can Integrate with any insurance carrier for enrollment eligibility management (e.g., Blue Cross, Blue Shield, Aetna, United Health Care, Kaiser, CIGNA and many others), and integrate with any payroll system for enrollment deduction management (e.g., Workday, ADP, Paylocity, PayCor, UKG, and many others).

Topics: Health Care Reform (ACA), Affordable Care Act, HR & Benefit Plans, Affordable Care Act (ACA)


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