Appeal PTCs Now, and Save Money Later

Has your employee sought premium tax credits (PTCs) for coverage under a health insurance marketplace? If so, this could be an opportunity for you to reduce your ACA penalty risk. When an employer receives notice from a health insurance marketplace that an individual is eligible for PTCs, the best course of action is to read the notice carefully and ask plenty of questions: What is the deadline to appeal? Is this individual still an employee? Are you an applicable large employer under the ACA? Is the employee full-time or part-time?  Was affordable, minimum value coverage offered to the individual? Did the individual enroll in employer-sponsored coverage? Because ACA penalties hinge on an individual’s receipt of PTCs in connection with marketplace coverage, a successful appeal can help employers lessen the risk that the IRS will impose ACA penalties in the future. So, although you may not be required to reply to notices describing employee PTC determinations, taking a proactive approach now can reap rewards later.

KMK Law articles and blog posts are intended to bring attention to developments in the law and are not intended as legal advice for any particular client or any particular situation. The laws/regulations and interpretations thereof are evolving and subject to change. Although we will attempt to update articles/blog posts for material changes, the article/post may not reflect changes in laws/regulations or guidance issued after the date the article/post was published. Please consult with counsel of your choice regarding any specific questions you may have.


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