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LEGAL: Important deadline looming for PPACA’s ‘Notice of Coverage Options’

Jeff Jones
Friday, Jun 28, 2013

Employers must provide notice to employees by Oct. 1

The Patient Protection and Affordable Care Act (PPACA) requires all employers covered by the Fair Labor Standards Act (FLSA) to provide all employees with a “Notice of Coverage Options.” The due date for the notice was originally March 1, but shortly before that date the Department of Labor (DOL) deferred the requirement until further notice. This month the DOL announced that employers must provide the notice to current employees by Oct. 1. Employees hired after Oct. 1 must receive a notice within 14 days of their start date.

The “Notice of Coverage Options” is intended to inform employees about their options for obtaining health insurance through their employer and/or through their state’s Health Insurance Exchange (which the government now calls the “marketplace”). The DOL has promulgated model notices, available at www.dol.gov/ebsa/healthreform/index.html. One model notice is intended for employers that do not provide health insurance; the other is intended for employers that do provide health insurance.

Employers do not have to use the model notices, but must provide all the information that is contained on the model notices to employees. This information includes basic information about the exchange/marketplace, contact information for the employer and basic information about availability of insurance through the employer. The model notice for employers that do provide insurance includes an optional section for the employer to provide detailed, employee-specific information as to eligibility and cost. Again, providing this level of personalized information is optional under the current rules.

Interestingly, because the status of the exchanges/marketplaces is so uncertain in most states (including Tennessee), the model notice does not require any specific information about the state’s marketplace. Rather, employees may simply be directed to HealthCare.gov, which is the main website for all consumer information on PPACA.

All employers covered by the FLSA must provide a notice to all employees, including part-time and full-time employees. The notice must be provided to exempt employees as well as non-exempt employees. The notice also must be provided in writing. It may be provided electronically, as long as the electronic delivery meets the requirements of the DOL’s electronic disclosure safe harbor at 29 C.F.R. 2520.104b-1(c).

Jeffrey G. Jones is a regional managing member for Wimberly Lawson Wright Daves & Jones PLLC. He can be reached at jjones@wimberlylawson.com.


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