Notice to Employees of Coverage Options Under Fair Labor Standards Act Section 18B

OMB 1210-0149

OMB 1210-0149

Section 18B of the FLSA, as added by section 1512 of the Affordable Care Act, generally provides that, in accordance with regulations promulgated by the Secretary of Labor, an applicable employer must provide each employee at the time of hiring (or with respect to current employees, not later than March 1, 2013), a written notice: 1. Informing the employee of the existence of Exchanges including a description of the services provided by the Exchanges, and the manner in which the employee may contact Exchanges to request assistance; 2. 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 (the Code) if the employee purchases a qualified health plan through an Exchange; and 3. If the employee purchases a qualified health plan through an Exchange, 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 model notice is being to provided by the Department to facilitate compliance with FLSA section 18B.

The latest form for Notice to Employees of Coverage Options Under Fair Labor Standards Act Section 18B expires 2023-06-30 and can be found here.

OMB Details

Notice to Employees of Coverage Options Under FLSA 18B (Private Sector)

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