The IRS released Notice 2014-69 which provides that health plans that fail to provide substantial coverage for in-patient hospitalization services or for physician services (or for both) referred to as Non-Hospital/Non-Physician Services Plan) do not provide the minimum value intended by the minimum value requirements for the employer mandate.
For an employer who has entered into a binding written commitment to adopt, or have begun enrolling employees in, a Non-Hospital/Non-Physician Services Plan prior to November 4, 2014 based on the employer’s reliance on the results of use of the MV Calculator (a Pre-November 4, 2014 Non-Hospital/Non-Physician Services Plan), they will not be penalized for not meeting the employer mandate for the 2015 plan year if that plan year begins not later than March 1 2015.
For employers who have have not entered into a written commitment to adopt or have begun enrolling employees in a Non-Hospital/Non-Physician Services Plan on or after November 4, 2014 or have a plan year that begins after March 1,2015, no relief will be given.
An employer that offers a Non-Hospital/Non-Physician Services Plan (including a Pre-November 4, 2014 Non-Hospital/Non-Physician Services Plan) to an employee:
(1) must not state or imply in any disclosure that the offer of coverage under the Non-Hospital/Non-Physician Services Plan precludes an employee from obtaining a premium tax credit, if otherwise eligible, and
(2) must timely correct any prior disclosures that stated or implied that the offer of the Non-Hospital/Non-Physician Services Plan would preclude an otherwise tax-credit-eligible employee from obtaining a premium tax credit.
Without such a corrective disclosure, a statement (for example, in a summary of benefits and coverage) that a Non-Hospital/Non-Physician Services Plan provides minimum value will be considered to imply that the offer of such a plan precludes employees from obtaining a premium tax credit. However, an employer that also offers an employee another plan that is not a Non-Hospital/Non/-Physician Services Plan and that is affordable and provides MV is permitted to advise the employee that the offer of this other plan will or may preclude the employee from obtaining a premium tax credit.
For a copy of the Notice, click on the link below: