Title: PML Formatting Template
Author: Hart, John
Last saved by: david.gay@calhr.ca.gov (David Gay)
Company: California Department of Human Resources

This PML is superseded by the HR Manual and is no longer active.
PML Number
2013-030
Title
Notice about the New Health Insurance Marketplace Coverage Options and Employee Health Coverage
Date Issued
September 4, 2013
Owner
Benefits and Training Division
Contact
Michelle Garbato
Health Policy Analyst 
(916) 323-0862
Michelle.Garbato@calhr.ca.gov
Signed By
Greg Beatty, Chief
Content
The purpose of this memorandum is to inform Human Resources staff of a requirement by the U.S. Department of Labor that employers issue a notice to employees about the new Health Insurance Marketplace created under the Affordable Care Act (ref. Department of Labor Technical Release No. 2013-02, dated May 8, 2013).  The Marketplace helps individuals and small businesses shop for, select, and enroll in high-quality, affordable health plans and also assists eligible individuals in receiving premium tax credits or coverage through other federal or state health care programs.  The Marketplace in California is known as “Covered California,” operated by the California Health Benefit Exchange.
Distribution Requirements
Departments must provide the Notice to all existing employees, regardless of their health plan enrollment status or part-time or full-time employment status.  This also includes employees on disability leave, leave of absence, etc. 
This Notice must be distributed to all employees no later than October 1, 2013.  New employees hired after October 1, 2013, must also receive the Notice within 14 days of the start of their employment.  Departments may distribute the Notice to employees by interoffice mail, first-class mail, or under the circumstance described below, electronically.  For electronic distribution, employees must use a computer as part of their daily, normal job function or have consented to electronic delivery in a manner that demonstrates that they can effectively receive the notice via electronic delivery, per the Department of Labor electronic disclosure safe harbor (ref. 29 CFR 2520.104b-1(c)).
The Notice may also be included with new hire packets, health enrollment materials, or other existing communications, provided that the Notice and the other materials are delivered in the manner and timeframe required.
Employer Information
There are several sections within the Notice that need to be completed prior to distribution (please refer to the attached sample for reference).  It is important that this information be accurate and complete, as it will be used by employees to complete applications for obtaining coverage through Covered California and for Covered California to validate information provided on applications. 
Two editable versions of the Notice can be found in the HR Net section of the CalHR website at: hrnet.calhr.ca.gov/CalHRNet/Home.
•	Notice Version A is for departments that process payroll under the State Controller’s Office; 
•	Notice Version B is for departments that process their own payroll or have a third-party payroll processer. 
Within the Notice, departments will need to: 
1.	Copy and paste their departmental letterhead into the empty header space provided in the Notice.  The Notice should not be copied and pasted into a blank copy of their departmental letterhead, as this may alter document formatting;
2.	Complete “Part B - Information about Health Coverage Offered by Your Employer,” which includes information such as:
•	Employer Name: Enter the name of the Department in box 3 of the Notice; 
•	Employer Identification Number (EIN): 
o	Departments that process payroll under the State Controller’s Office must use Notice Version A.  The EIN 94-6001347 is hard coded into box 4 in this version of the Notice;
o	Departments that process their own payroll or have a third-party payroll processer must use Notice Version B.  Enter the departmental EIN used for tax reporting purposes (e.g., W-2 forms) in box 4 of the Notice;
•	Employer Address (including city, state, and zip code):  Enter the employer address in box 5 and the employer’s city, state and zip code in boxes 7-9 of the Notice.  If the department has employees that work in different locations beyond headquarters, enter the address, city, state, and zip code of the employee’s specific work location;
•	Employer Phone Number:  Enter the employer phone number in box 6 of the Notice.  If the department has employees that work in different locations beyond headquarters, enter the phone number of the employee’s specific work location;
•	Employer Contact Information:  Enter the departmental contact (e.g., Health Benefits Officer, Personnel Officer) that is qualified to verify employee employment and healthcare information, should Covered California or Internal Revenue Service request it.  This includes entering the departmental contact’s name, phone number, and email address in boxes 10-12 of the Notice. 
Health Benefits Eligibility
The Notice specifies which employees are eligible for health benefits through the California Public Employees Retirement System (CalPERS).  Although not a required element of the Notice, it bears revisiting, for your information, that the following employees and dependents are not eligible for health benefits.
Employees not eligible for health benefits:
•	Employees whose appointment tenure is Temporary (except for TAUs);
•	Employees appointed to a Limited Term of 6 months or less;
•	Part-Time employees appointed to a time-base of less than half-time;
•	Employees appointed to an intermittent time-base, except for Permanent Intermittents who work the required hours during a control period.  Limited Term and Temporary Intermittents are not eligible for benefits, regardless of their hours of work.

Dependents not eligible for health benefits:
•	Former spouses and former registered domestic partners are not eligible under any circumstances (even if the employee was court-ordered to provide the ex-spouse/former domestic partner with health coverage);
•	Children age 26 and older;
•	Children of former spouses/registered domestic partners;
•	Disabled adult children age 26 or older who were not enrolled prior to age 26;
•	Relatives such as grandchildren, grandparents, parents, aunts, uncles, nieces, nephews, etc.;
•	Foster children;
•	Spouses/domestic partners of adult children; 
•	Live-in boyfriend or girlfriend and his/her children;
•	Anyone already enrolled in a CalPERS health plan through another subscriber.

The State’s cost for 2013 health benefits is approximately $12,000 per employee.  It is incumbent on departments to ensure that ineligible employees or dependents are not placed or maintained on the health benefits roll.
More Information
For more information, employees should contact Covered California directly at (888) 975-1142 with questions regarding the Health Insurance Marketplace.  Personnel Offices may contact Michelle Garbato at (916) 323-0862 or Michelle.Garbato@calhr.ca.gov with questions regarding this PML.