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Monday, 09 September 2013 21:40

Educating Employees About the Exchanges

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You have just issued your employees the Model Exchange Notice, so now what?

What do they need to know in the coming months and how will you educate them on the Exchanges, now called the Marketplaces?


First, Explain the Basics

  1. Connect for Health Colorado opens October 1st, 2013, and is the state online health insurance marketplace where individuals, families and small employers can shop, compare and purchase health insurance.
  2. Qualified individuals whose income is between 133 and 400 percent of the federal poverty level may receive a subsidy in the form of a refundable and advanceable tax credit when purchasing health insurance coverage through the Individual Marketplace.


If your company will continue to offer coverage to employees

Explain why your employer-sponsored plan is deemed affordable and considered adequate coverage (ie it covers the essential benefits and offers at least minimum value).

Let employees know that because your coverage is available to them and is considered both adequate and affordable, they will not qualify for premium tax credits in the Individual Marketplace.

Regardless of the legal definition of affordability, employees may feel the current coverage offered by the employer plan, especially for the dependents, is pricey. Employees may want to explore the option of placing children on the individual Marketplace to help alleviate the added premium expense for a dependent.

If you choose to discontinue group coverage all together

Take the time to inform your employees about the individual marketplace. Remind them of their obligation to carry coverage under the Individual Mandate, and the penalty they will pay (for 2014 the greater of $95 or 1% of income) if they don’t.  This would be great information for all employees, such as part-timers, who are not eligible for coverage.

Employees don’t have to navigate the Individual Marketplace themselves. Fall River can assist in setting up their account, and provide detailed instructions to help them find the best coverage for their family.

Whether your organization will continue coverage or not, the topics surrounding health care reform all have specific nuances require further explanation. Fall River welcomes the opportunity during your next open enrollment meetings to discuss these in detail. In the meantime, don’t hesitate to This email address is being protected from spambots. You need JavaScript enabled to view it. or give us a call at 303.369.3200 with any questions.

Read 4353 times Last modified on Monday, 14 September 2020 20:36
Amy De Lorenzo

Amy Johnston is an Account Manager with extensive experience working with both large and small employers as a broker.  In addition to five years of broker experience prior to joining Fall River, she also brings eight years of insurance carrier expertise.  Amy is an expert on ERISA, the Affordable Care Act, and other compliance issues.

Ms. Johnston received a Bachelor of Arts degree in Communications from Colorado State University. She is a Colorado native from Steamboat Springs, and loves spending time in the mountains with her husband, two children, and Tucker the cocker spaniel. She enjoys snowshoeing, hiking, and philanthropy work to promote education.