Overview

Employers have long been required to inform their employees about the benefits offered by their
organizations. In many instances, rules and required formats exist for conveying such information. In
general, such notices about health care benefits and the means of delivering them still stand under the
ACA and have been expanded. Moreover, under the ACA, employers will have opportunities, as they
have in the past, to provide additional communications to employees about the value, details, and
available educational tools of their benefits plan options.

The Employer’s Role

In most organizations, the primary responsibility for communicating to employees about benefits and
benefit options lies with human resources (HR). HR may also facilitate communications in both
directions between employees and management. And HR is usually in the best position within
management to know the organization's employees and to decide on the message and the medium
when communication to employees is necessary.

However, although HR tends to "own" the benefits-communication effort, HR is not always the primary
conveyor of information to employees. HR can sometimes serve strictly as the organizer of
communications delivered by other resources. Such resources can include insurance carriers, agents,
and brokers; financial advisers; third-party administrators (TPAs) of benefits programs; employee
assistance programs; professional communicators or facilitators; and health care reform navigators.

Principal Notices and Communications

A number of communications to employees are mentioned in the ACA and are generally required,
although penalties for employers that do not comply have been relaxed somewhat in a few instances.
The communications may be issued by the employer or, in some instances, maybe put out by insurers
or TPAs. Some of the ACA-required notices are expanded versions of benefits notices that have been
required for many years.

Exchange Notices

These notices are to provide employees with information about how to access and use state health
insurance exchanges. Topics in the exchange notices should include the existence of the exchanges, the
employer's health coverage (or lack of it), the services provided by the exchanges and information on
how employees can contact an exchange to request assistance

Summary of Benefits and Coverage

A summary of benefits and coverage (SBC) is a standard communication tool issued by employers'
health plan providers and by insurance companies. Among other things, SBCs summarize a plan's major
provisions such as covered benefits, limitations, and cost-sharing.

Summary Plan Description

A summary plan description (SPD), a benefits plan communication that has long been required of
employers, informs participants in an employer-sponsored benefit plan about the plan's provisions and
operating procedures

W-2 Reporting of Health Costs

The ACA requires employers to report the value of employees' health care coverage provided under an
employer-sponsored group health plan annually on the W-2 form

IRS FORM 1095 (HEALTH CARE INFORMATION FORM)

Employers subject to the ACA must distribute reporting forms to employees and file with the IRS. By
filing Forms 1095-C with the IRS and providing employees with copies, employers with 50 or more full-
time or equivalent employees show they offered eligible employees health coverage that was compliant
with the ACA. For smaller organizations, self-insured employers or insurance companies file and
distribute Forms 1095-B.

Employers must send their 1095-C forms to employees by January 31 (extended to March 2 in 2022),
and to the IRS by the end of February if paper filing, and by the end of March if filing electronically.
These dates have been extended at times, so employers will want to keep abreast of this information.

Additional Communications

Employers whose employees understand and like their benefits are said to be more apt to be satisfied
with their employer and willing to recommend the organization as a good place to work. Thus, it can be
important for an employer to make sure its health plan communications—even those not required by
laws such as the ACA—are thorough, readable, and informative.