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Healthcare Reform Resources: Model Notices Required This Month

written by Julie Young | October 11, 2013

Under the Patient Protection and Affordable Care Act (ACA), all employers subject to the Fair Labor Standards Act (FLSA) are required by the Department of Labor to provide a notice to each of their employees no later than October 1, 2013 that describes the healthcare coverage that will be available through the ACA’s Health Insurance Marketplace (Marketplace). An employer failing to deliver the notice would be violating the FLSA and the ACA, and may be subject to investigation and penalties. It’s not too late!

Because you may have employees who must receive the federally-mandated notice, we are providing this explanatory letter and the accompanying materials to help your congregation or organization comply with the federal requirements.
In 2010, the federal government enacted the ACA with the aim of increasing access to affordable healthcare benefits that provide a minimum standard of health benefits. When key parts of this healthcare statute take effect in 2014, individuals and small businesses will be able to buy health insurance through the Marketplace.

Individuals may apply for coverage and enroll in a health plan through the Marketplace starting October 1, 2013, with coverage starting January 1, 2014. However, church plans such as the Medical Trust are excluded by federal law from participating in the Marketplace.

If an employee currently enrolled in a Medical Trust plan wants to buy health coverage through the Marketplace, you, as the employer, must notify him/her that s/he will lose all employer contributions toward the cost of his/her healthcare coverage as well as the pre-tax treatment of any required employee contribution. There are other financial considerations as well. Please contact the diocesan office before proceeding.

Complying with the Federal Requirements – What Do You Need to Do?

You must provide a customized Model Notice to every employee within the prescribed time periods described below. In addition, the Medical Trust has developed some optional informational materials you may wish to distribute to your employees with the Model Notice. You can download the following documents at http://www.cpg.org/model-DHP:

  • Model Notice entitled New Health Insurance Marketplace Coverage Options and Your Health Coverage, prepared by the Department of Labor.
  • Model Cover Letter for Employees
  • Instructions for Completing the Model Notice
  • Frequently Asked Questions for Employees
  • Health Benefits Waiver Form

Fill out one copy of the Model Notice for each employee working in your congregation or organization, customizing it by employee. You must do this for all employees, even if they are part-time, not eligible for health benefits through the Medical Trust or have health coverage through another approved source. For your convenience, the Medical Trust has prepopulated part of the form and this is explained in the Instructions. The single monthly premium for the lowest cost plan in our diocese is the high deductible plan. Excluding HSA funding, the monthly premium is $505 per month. You will need this amount to complete Box 15(a) of the Model Notice.

Give a customized copy of the Model Notice to every employee by October 1, 2013 (or as soon as possible..

Give a customized copy of the Model Notice to any new employee within 14 days of the start date.

We also request that you return a copy (paper or electronic) of each completed Model Notice form to me by October 25, 2013, and within 14 days of any new hire.

The Instructions provides step-by-step assistance for completing the Model Notice, but if you have any questions, please contact Julie Young or your Regional Account Specialist at the Church Pension Group, Toni Marie Sutliff, TSutliff@cpg.org

For employers NOT participating in the DHP AND providing healthcare benefits, find the model letter below:

 

Model Letter/Template for Diocesan Administrators:

Communication with Church Employers NOT in the DHP, and providing healthcare benefits from a different source

Dear Vestry/Wardens/Administrator:

Under the Patient Protection and Affordable Care Act (ACA), all employers subject to the Fair Labor Standards Act (FLSA) are required by the Department of Labor to provide a notice to each of their employees no later than October 1, 2013 that describes the healthcare coverage that will be available through the ACA’s Health Insurance Marketplace (Marketplace). An employer failing to deliver the notice would be violating the FLSA and the ACA, and may be subject to investigation and penalties.

Because you may have employees who must receive the federally-mandated notice, we are providing this explanatory letter and the accompanying materials to help you comply with the federal requirements.

Some Background
In 2009, the General Convention of the Episcopal Church passed Resolution A177 and its associated canon, establishing the Denominational Health Plan (DHP) for all eligible clergy and lay employees (those scheduled to work 1,500 hours or more annually) in the domestic dioceses and requiring that healthcare benefits be provided through The Episcopal Church Medical Trust (Medical Trust). For a full explanation of the DHP, go to http://www.cpg.org/adminDHP

In 2010, the federal government enacted the ACA with the aim of increasing access to affordable healthcare benefits that provide a minimum standard of health benefits. When key parts of this healthcare statute take effect in 2014, individuals and small businesses will be able to buy health insurance through the Marketplace.

Individuals may apply for coverage and enroll in a health plan through the Marketplace starting October 1, 2013, with coverage starting January 1, 2014. If an employee currently enrolled in one of your health plans wants to buy health coverage through the Marketplace, you, as the employer, must notify him/her that s/he will lose all employer contributions toward the cost of his/her healthcare coverage as well as the pre-tax treatment of any required employee contribution. There are other financial considerations as well.

Complying with the Federal Requirements – What Do You Need to Do?

As you are a Church employer who is not participating in the Denominational Health Plan, and you are providing healthcare benefits from a different source:

Download the Model Notice prepared by the Department of Labor at http://www.dol.gov/ebsa/pdf/FLSAwithplans.pdf

Fill out one copy of the Model Notice for each employee working in your congregation or organization, customizing it by employee. You must do this for all employees, even if they are part-time, not eligible for healthcare benefits, or have health coverage through another source.

Give a customized copy of the Model Notice to every employee by October 1, 2013.

Give a customized copy of the Model Notice to any new employee within 14 days of the start date.

We also request that you return a copy (paper or electronic) of each completed Model Notice form to me by October 14, 2013.

As a courtesy, the Medical Trust has developed some optional informational materials you may wish to distribute to your employees with the Model Notice. These materials can be downloaded at http://www.cpg.org/model-nonDHP

We understand the next few months may be confusing for you and your employees. Included with this letter are some points of information about the Marketplace but these are not exhaustive. You should contact your benefits broker or health insurance carrier with any questions.

Faithfully yours,

Diocesan Administrator

 

The Episcopal Diocese of San Diego and its employees do not provide, and none of the information furnished in this message should be viewed as investment, tax, or legal advise.  The content of this message is provided for information purposes only.