The Law @ Work

Affordable Care Act Brings New Notice Requirements for Employers

As you know, certain provisions of the Affordable Care Act went into effect on October 1, 2013. What you may not know is that one of those provisions requires employers to send a written notice to all employees describing coverage options under the new Insurance Marketplace “exchanges.” Even employees who are ineligible for health coverage must receive the notice.

The law requires employers to send the notices by October 1, 2013, and even small employers are subject to the notice requirement.  The only exemption is for employers who are not covered by the Fair Labor Standards Act.  There is no fine or penalty for a delayed or absent notice.  But sending it is fairly easy, and your employees may be expecting it.  The notices can be sent electronically;  just note on the transmittal message that paper copies are available from HR.

A model notice for each employer to first complete and then distribute, is available online.  If your company offers health insurance, use this model:  If no insurance is offered, use this model:  Further explanations of the model notices are available here:

Other notice requirements that will now apply under the Affordable Care Act are:

  • “Patient protection notice,” alerting health plan participants to any plan rules regarding choosing a primary physician or pediatrician, to be included in open enrollment materials.
  • A benefits summary, usually a grid, to be included in open enrollment materials.
  • If the health plan formerly imposed lifetime limits on benefits, a notice announcing their removal.
  • If beneficiaries who are children are aging out, a notice is required, offering a brief extension of coverage.
  • New notices are required when benefits are denied.  Typically, insurers are providing this notice.
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