Employers may receive notices from the Department of Health and Human Services relating to Health Insurance Marketplace (Exchange) coverage. If an employee purchases Marketplace coverage with a tax credit, HHS informs the employee’s employer. This is so HHS can review the coverage offered by the employer and see if any penalties come into play.
An employer who receives a Marketplace Notice should review the information on the notice carefully to ensure that it is correct. If information on the notice is incorrect, the employer may wish to file an appeal. An employer may also wish to file an appeal if (a) the individual was not actually an employee, (b) the individual enrolled in employer-offered coverage, or (c) the individual waived employer-offered coverage. These factors influence the ability of the individual to receive a tax credit for Marketplace coverage.
To submit an appeal, use the form available here.
A process for reviewing and responding to HHS notices is an important part of an ACA compliance program. Employers should make sure to have procedures in place for addressing any notices received.