Is there any requirement for employers to actually inform employees of their eligibility?

Can a company take the position that it “offered” coverage even if it didn’t give its employees the paperwork, didn’t have a meeting, or didn’t mail anything out?


Answer

Starting 2015 employers with over 200 employees need to auto-enroll employees with an opt-out. Employers with less need to let their employees know about their health coverage options, then offer no more than a 90 day waiting period for coverage to start. We can't find a specific law at the moment, ACA or other-wise, that says "an employer must tell an employee about health coverage" that applies to smaller firms. However, it does seem rather shady to offer coverage and then hide the fact from an employee. Have to imagine that there are Department of Labor rules against this. In the Fair Labor Standards Act associated legislation perhaps?

We will keep looking. Please post below if you find the answer.

It's also worth noting that employers are expected to notify their employees about the Health Insurance Marketplace.

Learn more about what employers need to tell employees here.

Sec. 1511. Automatic enrollment for employees of large employers. Requires employers with more than 200 employees to automatically enroll new full-time employees in coverage (subject to any waiting period authorized by law) with adequate notice and the opportunity for an employee to opt out of any coverage the individual or employee was automatically enrolled in.

Sec. 1512. Employer requirement to inform employees of coverage options. Requires that an employer provide notice to their employees informing them of the existence of an Exchange. Also, if the employer plan’s share of the total allowed costs of benefits provided under the plan is less than 60 percent of such costs, that the employee may be eligible for a premium assistance tax credit and cost sharing reduction. Finally, if the employee purchases a qualified health plan through the Exchange, the employee will lose the employer contribution (if any) to any health benefits plan offered by the employer and that all or a portion of such contribution may be excludable from income for Federal income tax purposes.

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Jeff on

This may make sense to a government bureaucrat, but it does not translate well to the real world.

B on

My boyfriend was out on nine work related injury his employer did not file proper disability papers the wrong dates were put on by HR. This delayed his STD 11/4/15 till 12/26/15 he finally received a check foe past balance due. He was on FMLA. When he returned to work 2/9/16 the employer took his aquisition away. His insurance doubled. He has been employed there for 8 years now. His income is very low due to child support and his medical taxes, etc. We filed complaint with dept of labor in NJ. nothing was done. He now can not afford the increase in medical for 2017.

V on

I have worked for a large corporation for 14 years. They are requiring photocopies of birth certificates in order to keep our benefits. Can they do this? Is there a formal process to terminate our benefits if we don’t provide the document? In our state it is illegal ( Wisconsin statute 69.24 (1) to make photocopies of vital records and they are requiring only photocopies.