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?

1. 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
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 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 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
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
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* Source: 2015 ADP ACA Employer Confidence Study
Or call:
(as of May 2016)