Marketplace Exchange Notice Update

The late-June mass-mailing of Exchange Notices from federally run state Exchanges came with a ticking clock, and stated that employers had only 90 days to respond. As a reminder, these Notices were sent to employers of individuals who applied for Exchange-based coverage and were found to be eligible for advance payments of a premium tax credit or cost-sharing reductions for at least one month of 2016. Therefore, any employee named on an Exchange Notice had indicated that he or she was not offered an employer-sponsored plan, was offered an employer-sponsored plan that was unaffordable or did not provide minimum value, or that they were in a waiting period and unable to enroll in an employer-sponsored plan.

Since all of the federally run state Exchange Notices seem to be dated June 21, 2016, employers have until mid-September to appeal the Notices. Employers in receipt of Exchange Notices should consult with their legal and tax advisors to determine the appropriate response or appeal to each specific circumstance. Although the Notices make clear that potential 4980H penalties are handled through a separate IRS-led process, the appeal of the individual subsidy may prevent the IRS penalty process from even beginning.

ACAAdvantage customers refer their Exchange Notices to their First Advantage Account Consultant, who is highly informed about the ACA and Exchange Notice process. The Consultant assists with the appeal, based on the customer’s preferred response, and helps to keep the client informed and current with copies of all Exchange Notice appeal documentation.