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Employers: Don’t Forget to Provide Your Employees with Timely Notice Under the Affordable Care Act

Posted in New Legislation and Regulations

By  Lizbeth V. West

The Affordable Care Act (ACA) has many mandates for both individuals and employers.  While the main employer mandate facing certain large employers (the “play or pay” penalty) has been delayed until 2015, the ACA still requires employers who are otherwise covered by the federal Fair Labor Standards Act (FLSA), to provide a notice to their employees by October 1, 2013 explaining the new Health Insurance Marketplace (“Marketplace”).

An employer and its employees are covered under the FLSA if one of the following tests is met:

Enterprise Coverage

Employees who work for certain businesses or organizations (or “enterprises”) are covered by the FLSA.  These enterprises, which must have at least two employees, are: 1) those that have an annual dollar volume of sales or business done of at least $500,000; and 2) hospitals, businesses providing medical or nursing care for residents, schools and preschools, and government agencies.

Individual Coverage

Even when there is no enterprise coverage, employees are protected by the FLSA if their work regularly involves them in commerce between states (“interstate commerce”). The FLSA covers individual workers who are “engaged in commerce or in the production of goods for commerce.”

FLSA-covered employers must provide a notice regarding the Marketplace to all employees, including part-time, seasonal, temporary, and/or any other employee who may not otherwise be eligible for an employer-sponsored health plan.  The federal Department of Labor (DOL) has issued two different model notices – one for employers who offer coverage and one for employers who do not.  Copies of these model notices entitled “New Health Insurance Marketplace Coverage Options and Your Health Coverage” are attached for reference.

Finally, California’s Marketplace exchange (“Covered California”) provides more information and essentially serves as a “one-stop shopping” site to help individuals find health insurance that meets their needs and fits their budget.   See its website at: www.coveredca.com