Starting in the spring of 2016, the Health Insurance Marketplace (federally facilitated marketplace/FFM) will notify employers who have employees enrolled in Marketplace coverage and are receiving advanced premium tax credits (APTC). Employers will get notices if any employee received APTC for at least one month in 2016 and if the employee entered the employer’s address on his or her Marketplace application.
The notice will identify the specific employee and include a statement that the employee is enrolled in Marketplace coverage with APTC. The notices will not contain the employee’s personal health information or federal tax information.
These notices from the Marketplace are for information only. They do not determine if an employer has any liability under the employer shared responsibility provision. However, the IRS will independently determine if an employer has any such liability, regardless of whether the employer received a notice from the Marketplace or engaged in any appeals process.
An employer may appeal the Marketplace employer notice within 90 days of receiving it. The employer must assert that it provides access to affordable, minimum value coverage or that its employee is enrolled in employer coverage and is therefore ineligible for APTC. If the appeal is successful, the Marketplace will send a notice to the employee asking the employee to update his or her Marketplace application to reflect that he or she has access to or is enrolled in other coverage. The notice will also explain that failure to update the application may result in a tax liability.
For more information, please read the CMS FAQ.