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The Ultimate Guide To ACA Compliance

The ACA Mandate can be confusing. This guide shares what forms to use, fees, and other requirements to be compliant.

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The Ultimate Guide To ACA Compliance

  1. 1. The Affordable Care Act was created to help ensure all people have affordable healthcare options. And to give uncles everywhere something to gripe about. Like it or not, your company has to be ACA compliant. And even though we aren’t ACA consultants, we are employee data experts so we’re here to answer a few questions to make filing easier.
  2. 2. DoesACAapplytomysmallcompany? IF YOUR COMPANY HAD THEN YOU NEED TO 50 or more full-time employees (or full-time equivalents) in 2014 Comply with ACA requirements (However, companies that had between 50 and 99 employees in 2014 will not have to pay penalties.) Have been ACA-compliant for 2015 and file the appropriate tax forms in 2016 to prove that they were compliant More than 100 employees in 2014
  3. 3. Whatisconsideredfull-timeforemployees? The IRS considers any employee who works an average of 30 or more hours per week (or 130 hours each month) full-time. Keep in mind that part-time employees’ hours DO factor into how many full-time employees (or equivalents) you have. If you’re not sure how to determine the number, you can use this calculator to find out.
  4. 4. IfIofferhealth-carecoveragetoemployees, amIACAcompliant? Not necessarily. The following guidelines must apply to make sure the health coverage you offer is compliant: 1. Health coverage must provide a certain level of value. An ACA-compliant health plan needs to cover at least 60 percent of the total cost of an employee’s medical expenses. This should also include hospital and physician benefits. 2. Health coverage must be affordable. The coverage you provide can’t cost employees more than 9.5 percent of their annual household income for an individual plan. 3. However, some safe harbors exist in case you don’t know all your employees’ household incomes. For more information on how to calculate affordability, go here.
  5. 5. WhatfilesdoIneedtofileandwhen? All companies with more than 50 employees need to file the 1094-C and 1095-C forms with the IRS.
  6. 6. 1094-C: The form you file with the IRS that shows your company’s health- care coverage is ACA-compliant. It must be sent to the IRS by the end of May (for companies with fewer than 250 eligible employees) or June (if filed electronically for companies with more than 250 eligible employees). This form gives information about: • your company’s contact and tax information • your ACA tracking and reporting strategy (including if you’re using any Safe Harbors) • how many full-time employees you had during the year and if they were offered qualifying coverage For more extensive instructions about the 1094-C, visit the IRS web page.
  7. 7. 1095-C: the form you need to provide all full-time employees by January 31, 2016. You also must send these 1095-Cs to the IRS by the end of March. This form includes information about: • the type of health coverage offered and who it was offered to • the percentage of the premium the employee would have paid if they had employee-only coverage • enrollment, employment status, and if certain Safe Harbors were used to calculate affordability For more extensive instructions about the 1095-C, visit the IRS web page.
  8. 8. WheredoIgettheseformstofilewiththeIRS? You can download them right here from the IRS web site. Click Here For 1094-C Click Here For 1095-C
  9. 9. WhydoIkeephearingaboutSections 6055and6056? Sections 6055 and 6056 outline the reporting requirements companies must comply with that were created by the Affordable Care Act (ACA). Section 6055 applies to companies that have employees who are self-insured, while section 6056 applies to companies with at least 50 full-time employees. These reporting rules help companies know which information they need to report to the IRS and the health coverage they offer to employees. You can review more details of sections 6055 and 6056 on the IRS website.
  10. 10. Whatis“transitionrelief”anddoesmycompanyqualify? According to Section 4980H or Safe Harbor, companies who had 50-99 employees in 2014 may not be subjected to penalties in 2016 if they • average 50-99 full-time employees • don’t cut their workforce with the intent to qualify for “transition relief” • and their health coverage is maintained until the end of the year. In addition, Safe Harbor includes alternative methods of tracking your health plan’s affordability, your employees’ employment status, and enrollment for individual employees.
  11. 11. WhatisthepenaltyifmycompanyisnotACA-compliant? DoesACAapplytomysmallcompany? IF YOU DO NOT THEN YOU MUST PAY offer health coverage at all $2000 for every full-time employee excluding the first 30 employees $3000 for every full-time employee excluding the first 30 employees $200 for each missing form not received by the IRS $200 for each statement that should have been received offer “affordable” health coverage file the appropriate forms provide employees with the written statement The IRS will charge a penalty based on how many employees you have. (Although if you had fewer than 100 employees in 2015, penalties will not apply until 2016.) In addition, each of your employees may be fined if they are not covered with proper health insurance.
  12. 12. BambooHR can help you manage and report on some of the ACA information you need to be compliant (and sane). Give us a call at 1-866-387-9595 or click below to see how we can help. Informationoverload?Nosweat. SOURCES: http://www.irs.gov/instructions/i109495c/ar01.html#d0e296 http://www.irs.gov/pub/irs-pdf/p5196.pdf http://www.irs.gov/Affordable-Care-Act/Employers/Questions-and-Answers-on-Employer-Shared-Responsibility-Provisions-Under-the-Affordable-Care-Act#Identification CLICK HERE FOR A FREE TRIAL