Sample letter to employees about health insurance change

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Sample Letter to Accompany Health Insurance Model NoticeEmployer Backstreet Addressing, State and Zip CodeEmployee Name Employee Street Address City, State and Zip CodeDateRe: Health Insurance Marketplace

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You will receive the health insurance marketplaces' notices from your state health insurance exchange, which will provide you the notice. You are permitted to address this notice at your home, in your company office or to a public or private place of employment without having to provide a letterhead form. If you choose to address this notice to your employer, you are permitted to use the letterhead form provided. However, if you elect not to provide a letterhead form and you elect to send this notice via the mail, you will need to use the form shown above. The form includes instructions for mailing the statement and also asks you to enter your Social Security, Medicare, or other tax information (such as your income and assets). Please note that your health insurance company will not be required to provide you with the notice. If your insurance company does not provide you with the notice, they will no longer be required to pay for the coverage you are choosing. Accordingly, you are reminded that if you choose not to receive the notice, you may be required to pay a penalty. You understand that if you do not, the plan you select in 2014 will not be available to you in 2015. A Health Insurance Marketplace Notice is required to be provided to each employee, who is required to have health insurance, or may be required to pay a penalty as determined by the Office of Personnel Management (OPM). This requires you to provide a specific address where your employee's policy is mailed or delivered for purposes of filing Form 8950 with the IRS. We must also provide a specific mailing address for individuals and families who do not have health insurance. The Affordable Care Act requires that on the form provided, you list a specific address where your employee's policy(s) are mailed or delivered or both. This is what is called a State-specific Marketplace Notice. You may provide a health insurance carrier that has offered or offers employer sponsored coverage, such as an HMO or PPO. It does not matter what type of coverage your employee has, only that you use this carrier for their coverage. However, your employee needs to know this information is necessary for the tax form to be filed on your behalf. This statement should be sent from the address provided. We ask that all employees follow this practice. Once again, you are welcome to use the form as shown. The form will be printed and provided to you electronically. The Form 8950 will contain information from your Employee's Summary on Form W7ES, Employment Tax Return, but only if you provide it.

What is sample letter offering health insurance to employees Form?

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Instructions for the form sample letter offering health insurance to employees

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