Per the Affordable Care Act and operating regulations, each Health Insurance Marketplace must notify employers with employees determined eligible for advance premium tax credits and cost sharing reductions because the employee attested that he or she was neither enrolled in employer sponsored coverage nor eligible for employer coverage that is affordable and meets the minimum value standard.
Starting June 1, 2016, the Federally-Facilitated Marketplace (FFM) will send notices to employers
- (a) if the employee received a tax credit for at least one month in 2016 and
- (b) if the FFM has an address for the employer.
A sample notice may be viewed here.
If you receive such notice, you may opt to appeal. To do so, you must assert that the employee is ineligible for a tax credit because either
- (a) you provide employee access to affordable, minimum value, employer-sponsored coverage, or
- (b) the employee is enrolled in your group health plan coverage.
You will have 90 days from the date of the notice to submit an appeal. You can complete an Employer Appeal Form and fax to 877-369-0129, or mail to:
Health Insurance Marketplace
465 Industrial Blvd
London, KY 40750-0061