Exchange Notices: Clarifying a Complex Process

If you’re an employer with over 50 employees, and one decides to seek subsidized health coverage from an Insurance Marketplace/Exchange, you’ll likely face a complex web of paperwork, regulations, and processes driven by Exchange Notices. How you respond to Exchange Notices makes all the difference between remaining compliant with Affordable Care Act (ACA) regulations, and facing significant penalties.

Receiving an Exchange Notice

When an employee chooses health coverage from a Marketplace/Exchange and is granted a subsidy, you’ll receive an Exchange Notice.

  1. Employee seeks subsidized health care through a Marketplace/Exchange
  2. Subsidy Granted
  3. You receive an Exchange Notice
  4. Your Options: Pay a fine to the IRS or Appeal with Exchange or Department of  Health and Human Services

Appeals Trigger Research & Paperwork.
Lots of Research & Paperwork.

To prove you met the requirements of the ACA, you’ll need to manually find and combine information from multiple systems – unless you have a provider like Benefit Administration Group with the right systems and expertise.

PROVING YOU’RE IN COMPLIANCE TAKES THREE PIECES OF INFORMATION 

  1. Proof employee was offered coverage
  2. Proof coverage was affordable and provided minimum value
  3. Proof of your employee’s salary

The Reconciliation Process

Once you’ve gathered the right information, the reconciliation process filled with paperwork begins – and time is ticking.

Managing Exchange Notices and Penalties:
the ”Final Step.”

Your Offer of coverage doesn’t meet ACA requirements means YOU pay a fine.

Your offer of coverage meets ACA requirements mean NO fine but Government may try to recoup the subsidy from the employee.

Stay ahead of ACA requirements and let Benefit Administration Group guide you through the rough waters of the ACA.

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