Employers Should Plan To Address Employee Questions About The Health Insurance Marketplaces


Now that the deadline for employers to provide the public health insurance marketplace notices by October 1, 2013 has arrived, it is likely that employers (especially the human resource departments) will begin receiving questions about the information provided in the marketplace notice.  While employers should be careful not to make incorrect statements or misrepresentations about marketplace coverage or any employer-provided coverage that may be available, they should prepare to respond to the types of questions employees may have about the marketplace.  For example, when employees complete an application for marketplace coverage, they must also include a completed Employer Coverage Tool. Employees may ask for assistance with completing this document, so becoming familiar with the questions in the Employer Coverage Tool and formulating answers to those questions ahead of time may make it easier to answer the employee’s questions.  It is also likely that employees will ask about the individual mandate itself.  As a reminder, effective January 1, 2014, the individual mandate penalty for failing to have health insurance is the greater of (1) $95 per adult ($47.50 per child) up to $285.00 per household, or (2) 1% of 2014 household income.  These penalties will increase in 2015 and 2016.  Finally, employers can always encourage employees to visit the government’s website for the marketplaces at www.healthcare.gov for additional information.  Given the current climate of change surrounding health care coverage and the media attention on the public health insurance marketplaces, preparing in advance to answer employee questions will ease the additional administrative burden and help employers weather the storm.

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DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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