Episcopal Church Foundation Vestry Papers - for leading congregations

Attention Employers: ACA Marketplace Notices are due to all employees by October 1, 2013.
By Laurie Kazilionis, Senior Vice President, The Church Pension Group

It’s almost October 1 – Have you provided notice of the availability of healthcare coverage through the Marketplace (also called the Exchange) to your employees?

If you have, wonderful! If not, don’t panic. The Episcopal Church Medical Trust (Medical Trust) has created information and resources to help you comply with this provision of the Patient Protection and Affordable Care Act (ACA), which is sometimes referred to as “healthcare reform.”

Background

In 2010, the federal government enacted the ACA with the aim of increasing access to affordable healthcare benefits that provide a minimum standard of health benefits. When key parts of the ACA take effect in 2014, individuals and small businesses will be able to buy health insurance through the Health Insurance Marketplace (Marketplace).

The ACA requires that certain employers provide a notice (the Notice) to employees that describes this new Marketplace and contains information on the healthcare coverage the employer provides to its employees. The Notice must also inform employees that if they want to buy health coverage through the Marketplace, s/he will lose all employer contributions toward the cost of her/his healthcare coverage as well as the pre-tax treatment of any required employee contribution. The employee needs to be aware of the information contained in the Notice if s/he is considering applying for coverage through the Marketplace.

What do employers have to do to be in compliance?

Under the ACA, all employers subject to the Fair Labor Standards Act (FLSA) are required by the Department of Labor (DOL) to provide a customized Notice to each of their employees no later than October 1, 2013. The Notice must also be provided to new employees within 14 days of the date of hire.

Are you subject to the FLSA?

The DOL’s Wage and Hour Division provides guidance for determining whether an employer is subject to the FLSA. See www.dol.gov/elaws/esa/flsa/scope/screen24.asp.

Where can you find the Notice? On the CPG website!

To assist employers with the notification process, the DOL has issued two Model Notices – one for employers that offer health coverage and one for employers that do not offer health coverage.

• If you are participating in the Denominational Health Plan (DHP), you can download the Notice by going to the Church Pension Group (CPG) website at www.cpg.org/administrators/insurance/health-and-wellness/health-care-reform/model-policy-information. This form has been pre-populated with employee and dependent eligibility for Medical Trust coverage.

There you will also find the following additional materials that you may find useful:

• Instructions for completing the Model Notice
• FAQs that you can use when giving the Notice to your employees (Non-DHP employers may find these FAQs helpful, too.)
• A Health Benefits Waiver form that employees who are required to participate in the DHP must complete before purchasing coverage through the Marketplace. Note: There are various financial considerations that an employee should understand before proceeding so we strongly recommend that you contact your diocesan office before an employee completes this form.

Employers not participating in the DHP but providing healthcare benefits through another source can download the Model Notice prepared by the DOL at http://templatelab.com/FLSA-with-plans/.

You can also access these forms through the CPG website by using the link provided above.

For more information about the DHP, go to http://www.cpg.org/adminDHP.

To whom must employers provide the Notice?

Employers must provide the Notice to every employee, even if the employee is part-time, not eligible for the employer’s healthcare benefits, or has health coverage through another approved source. Employers are not required to provide the Notice to dependents or others who may be eligible for benefits but are not employees. We recommend you keep copies for your records.

For clarification regarding who is considered an employee by the IRS, go to http://www.irs.gov/pub/irs-pdf/p1779.pdf.

Need more help?

CPG and the Medical Trust are committed to helping Episcopal employers comply with the ACA. If you have questions about the requirement to provide this Notice, please email us at IBAMS@cpg.org.

Please note that this article is provided for informational purposes only and should not be viewed as legal, tax or other advice.