October 1 Deadline ACA Health Insurance Marketplace Notices

Most businesses – including optometric practices – are required by the federal Affordable Care Act (ACA) to notify their employees about the new Health Insurance Marketplace by Oct. 1, 2013. Whether you have two employees or 100, if you are subject to the Fair Labor Standards Act (FLSA), you must provide this Health Insurance Marketplace Notice.

Employers must provide these Health Insurance Marketplace notices to all full-time and part-time employees, regardless of eligibility or enrollment in health care plans. Practices also must give the notices to all new hires within 14 days of employment beginning October 1.




Background

The Health Insurance Marketplace is a new system of state health insurance exchanges authorized under the federal Affordable Care Act (ACA). New plans offered through the exchanges are scheduled to begin enrollment on October 1.

To prepare, optometrists must provide practice employees a written notice that informs them:

• About the Health Insurance Marketplace;

• That, depending on any coverage the practice offers, they may be able to get lower costs on private insurance in the marketplace based on their income;

• That if they buy insurance through the marketplace, they may lose the employer contribution (if any) to their health benefits.

Model notices available

The U.S. Department of Labor provides two model notices (PDFs) that help practices meet content requirements:

• Model notice for businesses that currently offer health insurance
• Model notice for businesses that currently do not offer health insurance

The model notices are interactive PDFs that can be saved to your computer, filled-in and printed. The model notices are also available in Spanish and in Microsoft Word format.

Who must comply with this requirement

The notification requirement applies to all businesses covered under the federal Fair Labor Standards Act (FLSA). FLSA basically applies to all businesses with gross revenues of $500,000 or more. The U.S. Department of Labor offers an interactive online guide to help business owners determine if they are covered under the act.

While businesses covered by the FLSA are required to provide a written notice to employees about the Health Insurance Marketplace, there is no fine or penalty under federal law for failing to provide the notice, according to the Department of Labor.

Additional Information on Implementation of the ACA

For additional guidance on employee notice requirements, see the federal government's FAQs or the Department of Labor's Technical Release 2013-02


OTHER INFORMATION:

Tools and resources on the Health Insurance Marketplace enrollment process and coverage options in Pennsylvania

Help for Pennsylvania small employers navigating the Health Insurance Marketplace

Access to Pennsylvania's Health Insurance Marketplace

Information on new opportunities for optometrists to participate in insurance plans and treat new patients

AOA Third Party Center resources and FAQs that explain the new marketplaces and assess participation in plans