Mark J. Goldstein, S.C. is a law firm that specializes
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Patient Protection and Affordable Care Act

Frequently Asked Questions (FAQ's) Regarding Upcoming Deadlines

Q: We are hearing so much about the October 1 PPACA deadline. What happens on October 1?

A: October 1 is the date by which employers must provide a “Marketplace Notice” (also known as a “Notice of Exchange Coverage”) to each employee. These notices advise employees of their right to seek coverage via the new Federal (or State) Marketplace (a/k/a Health Insurance Exchange).

Q: What is a Marketplace Notice and Where Can I Find One?

A: Model notices can be found at the U.S. Department of Labor’s website. If you offer group health coverage, go to: http://www.dol.gov/ebsa/pdf/FLSAwithplans.pdf. If you do not offer group health coverage, go to:http://www.dol.gov/ebsa/pdf/FLSAwithoutplans.pdf.

Spanish language versions can be found here: http://www.dol.gov/ebsa/pdf/FLSAwithplanssp.pdf and here: http://www.dol.gov/ebsa/pdf/FLSAwithoutplanssp.pdf.

Q: Who must provide the notification?

A: Employers are required to distribute a Marketplace Notice to all current employees by October 1, 2013, and to all new hires thereafter. This applies to all employers covered by the Fair Labor Standards Act (FLSA). In other words, even if you believe you are not covered by PPACA (e.g., you have fewer than 50 FTEs), you likely still have an obligation to distribute a Marketplace Notice to each employee.

Q: Can we provide the Notice electronically?

A: Yes, assuming the employee has computer access as a regular and integral part of their job duties (and for others upon written consent).

Q: Need we file anything with the U.S. Department of Labor, Internal Revenue Service, or Department of Health and Human Services certifying that we have done so?

A: No. Nothing needs to be filed with any federal agency.

Q: So what are the penalties for employers who do not provide the notifications to their employees?

A: The Department of Labor recently announced that there is no penalty for employers who fail to issue Marketplace Notices to their employees. There could be ERISA penalties (for employers that already sponsor ERISA plans).

Q: What are the dates for the initial Open Enrollment period for the Health Insurance Marketplace?

A: The initial Open Enrollment period for individuals to enroll in the Health Insurance Marketplace extends from October 1, 2013 through March 31, 2014. After 2014, the enrollment period is scheduled to run from October 15 through December 7 of each year. Unless there is a life event (birth of a child, marriage, divorce, etc.), individuals will need to wait until the following Open Enrollment period to enroll via the Health Insurance Marketplace.

Q: What does this mean for COBRA?

A: An amended model COBRA notice can be found at the U.S. Department of Labor’s website: http://www.dol.gov/ebsa/healthreform/index.html (new and redline versions).

Contact Kris (kris@goldsteinsc.com) with any additional questions you may have.