Appealing Marketplace Decisions & IRS Letters

Both the Health Insurance Marketplaces and the Internal Revenue Service (IRS) have begun sending letters to employers to enforce the Affordable Care Act’s employer shared responsibility provisions (also known as "pay or play"). Learn more about these letters below.

Health Insurance Marketplace Letters

Health Insurance Marketplaces must notify employers that one or more of their employees has been determined to be eligible for advance premium tax credits and cost-sharing reductions, and has enrolled in a Marketplace plan. Because these events may trigger penalties under pay or play, applicable large employers subject to these provisions—generally those employers with at least 50 full-time employees, including full-time equivalent employees—may seek to appeal an employee's eligibility determination.