KMK Law Management Rights Blog

Has your employee sought premium tax credits (PTCs) for coverage under a health insurance marketplace? If so, this could be an opportunity for you to reduce your ACA penalty risk. When an employer receives notice from a health insurance marketplace that an individual is eligible for PTCs, the best course of action is to read the notice carefully and ask plenty of questions: What is the deadline to appeal? Is this individual still an employee? Are you an applicable large employer under the ACA? Is the employee full-time or part-time?  Was affordable, minimum value coverage offered to the individual? Did the individual enroll in employer-sponsored coverage? Because ACA penalties hinge on an individual’s receipt of PTCs in connection with marketplace coverage, a successful appeal can help employers lessen the risk that the IRS will impose ACA penalties in the future. So, although you may not be required to reply to notices describing employee PTC determinations, taking a proactive approach now can reap rewards later.