Top 3 Things You Need to Know About Exchange Notices

Top 3 Things You Need to Know About Exchange Notices If your employee goes to an Insurance Exchange (or Marketplace) and receives a subsidy, the Exchange begins a complex trail of communication and paperwork with the employer to validate offering and earnings. What happens next? NOTICE NOTICE NOTICE Which states will notices be coming from? 1 NOTICE Where will these notices be sent? 2 LOOK OUT FOR NOTICES FROM THESE STATES Washington, DC The Notice will go to the address provided by your employee, which means it may not go where you expect. Office Mailroom Do these locations know what to do with these notices if they receive them? Franchise Branch Are you prepared? Employers feel least prepared to deal with Exchange Notices and other penalties that may arise from non-compliance.* Standardized Notice of Coverage process across your business Annual health care reporting (Forms 1094/ 1095-C) Offer of benefits coverage eligibility requirements Affordability requirements Penalty management process with the IRS Exchange Notice documentation, testing and processing with mulitple state and federal Exchanges 30% 40% 50% 60% 70% Only 45% Only 33% 41% 46% 55% 56% 57% 61% 42% 45% 45% 48% How should you respond? 3 When you receive an Exchange Notice for an employee, it is an opportunity to... EXCHANGE NOTICE Look at the coverage offered, if any Make sure you are in compliance from a penalty perspective If appropriate coverage is not being offered, it gives you a chance to make an offer and potentially limit the amount of penalty assessed by the IRS If you offered affordable coverage consider appealing the Exchange Notice. It could limit the amount of money the employee has to repay if their determination of premium tax credit (PTC) is reversed. Organizations with 50-99 employees Organizations with 1,000+ employees Areas in which organizations feel extremely or very prepared for: Penalties? What penalties? Organizations are generally aware of the penalties resulting from non-compliance with ACA requirements, but they are least aware of the consequences pertaining to Exchange Notice management.* NOTICE NOTICE NOTICE penalty penalty penalty of organizations are aware of the importance of Exchange Notice management STATES ALREADY SENDING OUT NOTICES Just under 50% Unlike more straightforward payroll or corporate tax management, staying compliant with ACA mandates depends on many factors. Be sure to choose a partner that will work with you to get your systems, processes and staff moving in the right direction — toward a compliant ACA strategy. NOTICE www.adp.com/health-care-reform 855-237-2650 Get informed with insights and guidance at: ADP and the ADP logo are registered trademarks of ADP, LLC. ADP – A more human resource is a service mark of ADP, LLC. Copyright © 2016 ADP, LLC. ALL RIGHTS * Source: 2015 ADP ACA Employer Confidence Study Or call: (as of May 2016)

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Transcript of Top 3 Things You Need to Know About Exchange Notices

Top 3 Things You Need to Know AboutExchange Notices

If your employee goes to an Insurance Exchange (or Marketplace) and receives a subsidy, the Exchange begins a complex trail of communication and paperwork with the employer to validate offering and earnings. What happens next?

NOTICE

Which states will notices be coming from?1

NOTICE

Where will these notices be sent?2

LOOK OUT FOR NOTICES FROMTHESE STATES

Washington, DC

The Notice will go to the address provided by your employee, which means it may not go where you expect.

Office Mailroom

Do these locations know what to do with these notices if they receive them?

Franchise Branch

Are you prepared?

Employers feel least prepared to deal with Exchange Notices and other penalties that may arise from non-compliance.*

Standardized Notice of Coverage process across your business

Annual health care reporting (Forms 1094/ 1095-C)

Offer of benefits coverage eligibility requirements

Affordability requirements

Penalty management process with the IRS

ExchangeNoticedocumentation, testing and processing with mulitple state and federal Exchanges

30%

40%

50%

60%

70%

Only45%

Only33%

41%

46%

55%56%57%

61%

42%45%45%

48%

How should you respond?3When you receive an Exchange Notice for an employee, it is an opportunity to...

EXCHANGE NOTICELook at the coverage

offered, if any

Make sure you are in compliance from a

penalty perspective

If appropriate coverage is not being offered, it gives you a chance to make

an offer and potentially limit the amount of penalty assessed by the IRS

If you offered affordable coverage consider appealing the Exchange Notice. It could limit the amount of money the employee has to repay if their determination of premium tax credit (PTC) is reversed.

Organizations with 50-99 employees

Organizations with 1,000+ employees

Areas in which organizations feelextremely or very prepared for:

Penalties? What penalties?Organizations are generally aware of the penalties resulting from non-compliance with ACA requirements,

but they are least aware of the consequences pertaining to Exchange Notice management.*

NOTICE

penalt

penaltypenalty

of organizations are aware of the importance ofExchange Notice management

STATES ALREADY SENDING OUT NOTICES

Just under 50%

Unlike more straightforward payroll or corporate tax management, staying compliant with ACA mandates depends on many factors. Be sure to choose a partner that will work with you to get your systems, processes and staff moving in the right direction — toward a compliant ACA strategy.

NOTICE

www.adp.com/health-care-reform

855-237-2650

Get informed with insights and guidance at:

* Source: 2015 ADP ACA Employer Confidence Study

Or call:

(as of May 2016)