What You Need to Know About Health Insurance Notices

What You Need to Know About Health Insurance Notices

You may be notified by a Health Insurance Exchange that one of your employees has received a government subsidy for individual health insurance coverage.

Section 1411 of the Affordable Care Act (ACA) forces the government to verify the eligibility of people who receive financial subsidies for individual health insurance through a Marketplace. Starting in the spring of 2016, Marketplaces will begin sending notices to the employers of those individuals of the people who have received subsidies for individual health insurance. If you are worried about any fees or anything like that, there’s no need. Marketplaces do not enforce the ACA’s “play or pay” rules, and cannot assess penalties on employers. Here are answers to common questions regarding the Marketplace and the notifications you may receive.

What are these notices?

These notices, also called 1411 Certifications, are part of the government’s verification efforts regarding people who received Marketplace subsidies for individual health insurance. The Marketplaces just want to make sure that the individual was eligible for, or enrolled in, the employer’s health since that information may affect their eligibility for subsidies.

What information will be on this notice?

This notice may identify only one employee who provided the employer’s name and address when they were applying for health insurance. With each notice, it identifies the employee and indicates that they have been determined eligible for a marketplace subsidy.

The Marketplaces do not access penalties; only the IRS can assess the penalties, which is a separate process and expected to begin later this year.

For information on how this process will affect employers of nonprofits, contact the experts at Colorado Nonprofit Insurance Agency in Denver, Colorado. We will work with you to ensure you are getting the most out of your coverage.