As Burri Predicted: Catholic Religious who file for coverage on the Marketplace are triggering penalty notices from the HHS.

As Burri Predicted:  Catholic Religious who file for coverage on the Marketplace are triggering penalty notices from the HHS.

Catholic Religious orders are receiving penalty notices that are being triggered by Catholic Religious members obtaining healthcare coverage through the marketplace.


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The Federal Data Services Hub doesn't "speak Catholic"

To enforce the penalties of the Affordable Care Act (ACA), the Department of Health and Human Services (HHS), the Department of Labor (DOL) and the Internal Revenue Service (IRS) have assembled, perhaps, the most massive collection (and sharing) of data between federal agencies and private entities in U.S. history.  They have accomplished this by building a giant network of computerized databases called the "Federal Data Services Hub" (Data Hub). [1]
In order to be eligible for coverage through marketplace, an applicant must certify that either the employer did not offer coverage, or the coverage that was offered did not meet affordability or provide minimum value.  Each of these three certifications alone is grounds for the employer to be subject to significant penalties under the ACA.  When a Catholic Religious applies for coverage through the marketplace, they can cause their religious order to be flagged for the "employer" penalty by the HHS.  For this purpose, it does not matter if the Order calls its religious "members" or any other descriptive name.  Unfortunately, the Data Hub treats Catholic Religious just like any other secular employee of a secular company.  When a Catholic religious buys insurance on the marketplace, the Data Hub matches the social security number of the Catholic Religious with the Employer's information [2] and this automatically triggers a penalty notice. 

URGENT and careful response required

If you receive a notice like this from the HHS, it is important that you respond quickly.  You have only 90 days to appeal.  If you fail to appeal in a timely manner, and in correct form, you will put your organization at risk of significant penalties. [3]  Further, the substance of the appeal must address the unique controlled-group issues that apply to Catholic entities.  These issues are too varied and numerous to discuss here, but our ERISA and ACA attorneys would be happy to discuss your organizations specific issues with you, anytime.

If you have questions or need help filing an appeal, you can email our separate law firm at: , or call (305) 998-0408 for more information.