If you’re an employer, you can appeal if the Marketplace said the coverage you offered your employees doesn’t meet the minimum standard requirements by law.
The Health Insurance Marketplace doesn’t decide if you’re subject to a fee. The IRS makes this decision.End highlighted text
If your business applied for the Small Business Health Options Program (SHOP), learn how to appeal a Marketplace decision about participating in SHOP. You can also get information about SHOP eligibility appeals by calling 1-800-706-7893. TTY users can call 711.
Your appeal needs to let the Marketplace know that your employee(s) were enrolled in or offered health coverage that meets minimum value. You must be able to show that the employee coverage you offer is both:
If you file an appeal, it won’t change whether you have to pay the IRS fee. You’ll have to file a separate appeal with the IRS for the fee.End highlighted text
The outcome of your appeal may impact whether your employees (and any of their household members) qualify for cost savings and premium tax credits through the Marketplace.
Employees enrolled in employer coverage, or offered affordable health coverage that provides minimum value aren’t eligible for savings through the Marketplace. They may have to pay back some or all of the savings they got in the past.
When you file an appeal, your employees will get a letter describing the appeals process, how it may affect their eligibility for savings, their rights, and how to submit documents to be considered in the appeal.
Your business has 90 days from the date on the Marketplace notice to file an appeal.
2 ways to file your appeal:
Complete the appeal form Include copies of documents that verify:
Send a letter that includes your:
Mail or fax your completed form or letter to the Marketplace Appeals Center:
Health Insurance Marketplace Attn: Appeals 465 Industrial Blvd. London, KY 40750-0061 Secure fax: 1-877-369-0130