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Avionté ACA - Notice of Health Exchange

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What is a Notice of Exchange?

Employers covered by the Fair Labor Standards Act (FLSA) are required to provide a notice to employees about the health insurance marketplace/exchanges of the state(s) in which they operate. Employers have been required to provide this notice to current employees and new employees at the time of hire since Oct. 1, 2013. Employers are not required to provide a separate notice to dependents or other individuals who are or may become eligible for coverage under the plan but who are not employees.

 

A typical Notice of Exchange is organized into two parts, Part A and Part B. A sample Notice of Exchange PDF is available for download at the bottom of this article. Images from that sample are shown here:

  • Part A provides general information the Health Insurance Marketplace and how an employer offers coverage.



  • Part B provides details specific to what an employer offers for insurance coverage. The Avionté application provides data to automatically populate these fields in an electronic version of the document. Those details are provided further on in the Notice of Exchange eDocument section of this article.

 

Current employees must receive the notice in writing. New hires must receive the notice at the time of hire. The notice may be distributed electronically or by hard copy. There is no requirement to obtain an employee's signature, however, an employer may want to track delivery and receipt of the notice.

 

The notice must inform the employee:

  • Of the existence of the marketplace (referred to in the statute as the exchange) including a description of the services provided by the marketplace, and the manner in which the employee may contact the marketplace to request assistance.

  • If the employer plan's share of the total allowed costs of benefits provided under the plan is less than 60 percent of such costs, that the employee may be eligible for a premium tax credit under section 36B of the Internal Revenue Code if the employee purchases a qualified health plan through the Marketplace.

  • If the employee purchases a qualified health plan through the Marketplace, the employee may lose the employer contribution (if any) to any health benefits plan offered by the employer and that all or a portion of such contribution may be excludable from income for Federal income tax purposes.

 

The U.S. Department of Labor has two model notices to help employers comply. One model is for employers that do not offer a health plan and another model is for employers that offer a health plan to some or all employees:

The model notices are also available in Spanish and MS Word format at http://www.dol.gov/ebsa/healthreform/.

 

The Notice of Exchange should be included with your onboarding paperwork. If your company is offering a healthcare plan, you also need to include the Summary of Benefits & Coverage (SBC). OSHA monitors compliance to this rule.

 

 

Notice of Exchange eDocument

The Notice of Exchange (NOE) eDocument is an electronic version of the Notice of Exchange. The NOE is populated by fields mapped from your Admin Tools. This article provides the locations of the fields, the value option, and the actions that result.

 

 

View ACA-Related Employer Admin Tools

The majority of the data used in this eDocument is pulled from the Employer Admin Tools. Use the following instructions to view the used data in Employer Admin Tools.

 

  1. On the Start page, select Admin Tools from the Actions menu.

  2. Choose Employer from the left panel of the Admin window.

  3. Double-click the employer name in the right panel.

  4. The Detail tab is shown by default. Enter "ACA" into the top cell of the Property column to view the property values that will be used to build you eDocument. 

 

 

Supplier Admin Tools

Some of the data used in the Notice of Exchange eDocument is pulled from your Supplier Admin Tools. Use the following instructions to access the Supplier Admin Tools.

 

  1. On the Start page, select Admin Tools from the Actions menu.

  2. Choose Employer from the left panel of the Admin window. 

  3. Double-click the employer name in the right panel.

  4. Select the Branch tab when the Employer Admin Tools load.

  5. Within the Branch tab, select the Add/Edit button.



  6. Select the Branch from the list when the Details window loads.
    The Details window includes the branch name, address and phone number, as well as the Property list. Some of these property values will be used within your eDocument.

 

 

Population of Part B Fields from Avionté

The following chart displays the data used in the Notice of Exchange eDocument which is pulled from both your Employer and Supplier Admin Tools.

 

 

Employer Information Employer/Supplier Admin Tools

Question

Field

Window

Field

Action

3

Employer Name

Employer

Details

Populate name field

4

Employer Identification Number

Employer

Details

Populate FEIN field

5

Employer Address

Branch

Address

Populate street field

If Branch is Null then

Employer

Address

Populate street field

6

Employer Phone Number

Branch

Contact Method

Populate phone field

If Branch is Null then

Employer

Contact Method

Populate phone field

7

City

Branch

Address

Populate city field

If Branch is Null then

Employer

Address

Populate city field

8

State

Branch

Address

Populate state field

If Branch is Null then

Employer

Address

Populate state field

9

Zip Code

Branch

Address

Populate zip code field

If Branch is Null then

Employer

Address

Populate zip code field

Question

Field

Employer Admin Tools

Action

10

Contact

ACA_EEN_PlanContact

Populate contact field

11

Contact Phone Number

ACA_EEN_PlanContactPhone

Populate phone field

12

Email Address

ACA_EEN_PlanContactEmail

Populate email field

 

Note: Only those offering a Notice of Health Exchange with Plan should continue.

 

 

Employer Offering

The coverage offered by the employer is discussed in the Employer Offering section of the Notice of Exchange.

Note: If your company is offering a healthcare plan which meets the requirements listed in the eDocument, data from your Admin Tools will populate this section.

 

 

Employer Offering

Employer Admin Tools

Item

Field

Field

Value

Action

1

Offer a Health Plan to:

ACA_EEN_OfferPlan

All

Check box 1

Some

Check box 2, go to 1a

1a

Eligible Employees are:

ACA_EEN_Eligible Employees

Free Text

Populate text field

2

Dependents:

ACA_EEN_Dependednts

Yes

Check box 1, go to 2a

No

Check box 2

2a

Eligible Dependents:

ACA_EEN_EligibleDependednts

Free Text

Populate text field

3

Meets Minimum

ACA_EEN_MEC

True

Check box is checked

False

 Check box is not checked

 


Employee Eligibility

The data populated into the Employee Eligibility section is pulled from the employee record in your Avionté Core Application.

 

 

Eligibility

Core Application

Question

Field

Field

Value

Action

13

Employee Eligibility

Employee > Payroll > ACA Eligibility

Yes

Check box 1, go to 13a

Undetermined

Check box 1

No

Check box 2

13a

Eligibility Date

Stability End Date

(mm/dd/yyyy)

Populate field

Null

Blank field

 

 

Minimum Standards

If the employee was NOT eligible for coverage, it is not necessary to complete the remainder of the form.

The data for this section is pulled from Config Options in Admin Tools.

 

 

Employer Offering

Config Option

Question

Field

Field

Value

Action

14

Meets Minimum

Admin Tools > Config Option > HealthcarePlanOffered

True

Check box 1

False

Check box 2

 

 

Set Config Option

If the offered coverage does NOT meet the minimum value standard, it is not necessary to complete the remainder of the form.

Use the following instructions to access the Config Option of HealthcarePlanOffered.

 

  1. On the Start page, select Admin Tools from the Actions menu.

  2. Choose System from the left panel of the Admin window.

  3. Double-click Config Option in the right panel.

  4. Select the Config Option By FKName tab.

  5. Search for "Healthcare" in the Property column.

  6. The Default Value is set to either True or False.

 

 

Premiums

The data which populates the premium amount field and the premium frequency field is pulled from your Employer Admin Tools.

 

Premiums

Employer Admin Tools

Question

Field

Field

Value

Action

15a

Premium Amount

ACA_EEN_Premium

$00.00

Populate currency field

15b

Premium Frequency

ACA_EEN_PremiumFrequency

Weekly

Check weekly box

Every 2 weeks

Check every 2 weeks box

Twice a month

Check twice a month box

Monthly

Check monthly box

Quarterly

Check quarterly box

Yearly

Check yearly box

 

 

New Plan

If the plan year will end soon and you know that the health plans offered will change, continue with question 16. If you are not certain of upcoming changes, stop here.

 

New Plan Year

Employer Admin Tools

Question

Field

Field

Value

Action

16

Offer Coverage

ACA_EEN_NewPlanYr

No

Check box 1

Yes

Check box 2, go to 16a

16a

Premium Amount

ACA_EEN_NewPlanPremium

$00.00

Populate field, go to 16b

16b

Premium Frequency

ACA_EEN_NewPlanFrequency

Weekly

Check weekly box

Every 2 weeks

Check every 2 weeks box

Twice a month

Check twice a month box

Monthly

Check monthly box

Quarterly

Check quarterly box

Yearly

Check yearly box

 


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