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Under the health care law, certain employers with 50 or more full-time employees (or equivalents) must offer health insurance coverage to their full-time employees (and their dependents) that meets certain minimum standards or pay a fee called the Employer Shared Responsibility Payment.
Employers that get a notice from the Marketplace stating they may be subject to the fee can file an appeal if they believe they offered coverage to an employee that both:
This appeal may determine if an employee (and any household members) got help with costs through the Marketplace at the same time their employer offered them affordable health coverage that met the minimum value standard.
IMPORTANT: This appeal will NOT determine if an employer has to pay the fee. Only the Internal Revenue Service (IRS), not the Health Insurance Marketplace or the Marketplace Appeals Center, can determine which employers are subject to the fee. Learn more about the Employer Shared Responsibility Payment on IRS.gov.
Employers have 90 days from the date stated on the notice from the Marketplace to file an appeal. This appeal can be filed 2 ways :
Mail your appeal request form or letter and a copy of the Marketplace notice to this address:
Department of Health and Human Services
Health Insurance Marketplace
465 Industrial Blvd.
London, KY 40750-0061
You may also fax the form to a secure fax line: 1-877-369-0131.
You’ll receive all future correspondence about this appeal from the Marketplace Appeals Center. The Marketplace Appeals Center is different from the Health Insurance Marketplace.
The employer will get a letter saying the appeal was received. It will provide a description of the appeals process and instructions for submitting additional materials if needed.
If your employer requests an appeal through the Marketplace Appeals Center, you’ll get a letter describing:
Visit the Marketplace language resource page.
Have questions about the health care law and business? Contact the ACA Employer Call Line at:
Have questions about an appeal? Call the Marketplace Appeals Center at:
Hours of operation for both numbers are Monday through Friday 9:00 a.m. to 7:00 p.m. ET.