Under the Affordable Care Act (ACA), MNsure is required to notify employers when an employee enrolls in a qualified health plan (private insurance) through the exchange and is determined eligible for discounts on health insurance purchased through the MNsure marketplace to help pay for coverage. These discounts are known as an advanced premium tax credit (APTC) or cost sharing reductions (CSR).
MNsure sends the employer notice when it determines an employee is eligible for APTC or CSR because the employee reported that his or her employer either:
Did not offer health care coverage; or
Did offer health care coverage, but it did not provide minimum value or was unaffordable to the employee.
If the employee listed on the notice enrolled in a qualified health plan and other conditions are met, then the employer may have to pay an employer shared responsibility payment to the Department of the Treasury. (26 U.S.C. § 4980H). The IRS determines whether an employer is liable under the employer shared responsibility provisions. MNsure does not determine the employment status of the employee or liability of the employer.
Though employers of any size can receive an employer notice, there are many situations in which an employee receives APTC or CSR and the employer is not liable for the tax penalty. For example, generally only large employers with at least 50 full-time or full-time equivalent employees might have to pay an employer shared responsibility payment for any month that at least one full-time employee enrolled in coverage through a health insurance marketplace and received APTC or CSR. The IRS provides information about the ACA provisions for employers, requirements for applicable large employers and the employer shared responsibility provision.
Employers who receive this notice have the right to appeal the employee's APTC eligibility determination.
MNsure mails the employer notice to the employer address provided by the employee. If an employer receives the notice at a location other than its legal headquarters, it is the employer's responsibility to forward the notice to the contact responsible for compliance with employer shared responsibility.
Blue Cross Blue Shield (BCBS) has made the decision to stop offering health insurance coverage in the individual market in Minnesota, both on and outside of MNsure. This means BCBS enrollees must take action to remain insured in 2017. MNsure mailed a letter (PDF) to its customers enrolled in a BCBS plan about this event.