Guest Post: Will Your Employer Miss The October 1 Deadline For Obamacare Notice?

By Associate Attorney who now chooses to be anonymous, Donna M. Ballman, P.A., Employee Advocacy Attorneys

October 1, 2013 is the first day employees can officially sign up for the Affordable Care Act, a/k/a “Obamacare.” Although you can sign up for Obamacare starting on this date, no one will actually get coverage until January 1, 2014. The gap between enrollment and enactment provides the government and insurance companies time to ease into the new program and make any necessary adjustments for a smoother transition. Open enrollment in the program does not end until late March 2014.

Your employer is supposed provide written notice to all existing employees and any new employees hired, beginning on October 1, 2013. A notice is timely issued if provided within 14 days of an employee’s start date.Your employer is probably going to miss this deadline.

Many small businesses reported that they were unaware of the notice requirements and feared potential risk to penalties. As a result, the Department of Labor (DOL) posted a notice on its website stating that employers cannot be fined for failing to provide the notice. Unfortunately, although the notice is a “requirement,” DOL stated, “If your company is covered by the Fair Labor Standards Act, it should provide a written notice to its employees about the Health Insurance Marketplace by October 1, 2013, but there is no fine or penalty under the law for failing to provide the notice.” [Donna's comment: on the other hand, if employees miss any deadline, just see what happens to them. Fair? Ha!]

The main focus of Obamacare is the establishment of the Health Insurance Martketplace (“Marketplace”), which is set to start on January 1, 2014. The Marketplace provides “one-stop shopping” for consumers to find and compare private health insurance options. Section 1512 of the law requires employers to provide employees notice of the coverage options available to them through the Marketplace. Your employer must provide the notice to each employee regardless of their health plan enrollment status or whether or not the employee works part-time or full-time. However, employers are not required to provide notice to dependents or those who may became eligible for coverage but who are not employees.

The notice to employees must: (1) inform you of the existence of the Marketplace, description of services provided by the Marketplace, and ways to contact the Marketplace for assistance; (2) inform you that if the employer plan’s share of the total allowed costs of benefits provided under the plan is less than 60% of such costs, you may be eligible for a premium assistance tax credit and cost sharing reduction; and (3) if you purchase a qualified health plan through the Marketplace, you may lose any employer contribution to any health benefits plan offered by the employer, and all or a portion of such contribution may be excludable from income for Federal income tax purposes.

DOL provides model notices on their website, which is worth looking at if you are considering exploring the Marketplace options, especially since your employer may not send you the notice. The website provides two model notices, one for employers who do not offer a health plan and another for those who do offer a health plan to some or all employees. Employers are not required to use the model notices, as long as the written notice they do provide meets the requirements discussed above.

It is worth looking into the Marketplace even if you are already covered, because you may find more affordable or more comprehensive coverage there.