Fluent in Practice Management

Beginning January 1, 2014, individuals and employees of small businesses will have access to insurance coverage through the Affordable Care Act’s (ACA) health insurance exchanges (Exchanges). Open enrollment under the Exchanges will begin on October 1, 2013. ACA requires employers to provide all new hires and current employees with a written notice about the Exchanges.

On May 8, 2013 the Department of Labor (DOL) released temporary guidance on the Exchange notice requirement. This temporary guidance will remain in effect until the DOL issues regulations of other guidance.

The Exchange notice requirement applies to employers that are subject to the FLSA. In general, the FLSA applies to employers that employ one or more employees who are engaged in, or produce goods for, interstate commerce. In most instances, a business must have at least $500,000 in annual volume of sales or receipts to be covered by the FLSA.

Required content for the Exchange notice:

• Inform employees about the existence of the Exchange and describe the services provided by the Exchange and manner in which the employee may contact the Marketplace to request assistance.
• Explain how employees may be eligible for a premium tax credit or a cost-sharing reduction if the employer’s plan does not meet certain requirements.
• Inform employees that if they purchase coverage through the Exchange, they may lose any employer contribution toward the cost of employer-provided coverage, and that all or a portion of this employer contribution may be excludable for federal tax purposes.

Employers must provide the Exchange notice to both new hires and current employees as follows:

·         New Hires – Employers must provide the notice to each new employee at the time of hiring beginning October 1, 2013. For 2014, the DOL will consider a notice to be provided at the time of hiring if the notice is provided within 14 days of the employee’s start date.

• Current Employees – For employees who are current employees before October 1, 2013, employers are required to provide the notice no later than October 1, 2013.

The DOL has provided two model Exchange notices:

• Employers who do offer a health plan – http://www.dol.gov/ebsa/pdf/FLSAwithplans.pdf
• Employers who do NOT offer a health plan – http://www.dol.gov/ebsa/pdf/FLSAwithoutplans.pdf

The Oregon Exchange is Cover Oregon.  They have information on how Cover Oregon will work, how to qualify and when they will process enrollments.

If you have any questions regarding the Exchange notice, please contact our office.