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.