benefitexpress October 21, 2019 6 min read

The Employer Roadmap to ACA + Surviving this Year's Reporting Season

ACA reporting 2020

You know what they say – when one door closes another one opens. That’s especially true in the world of HR and benefits compliance, when open enrollment season ends, and ACA reporting season begins.

While the fundamentals of the Affordable Care Act are important, the legislation in 2010 and accompanying paperwork presented a whole new area of focus for Human Resources practitioners. Namely, the responsibility of distributing reporting forms to employees and filing with the IRS.

That said... ACA reporting season is coming up! Are you ready? Here are our tips on surviving this year’s ACA deadlines.

Let’s start with a refresher: What is the ACA?

Also known as Obamacare, the Patient Protection and Affordable Care Act (ACA) was signed into law in March of 2010. The law has 3 primary goals:

  1. Provide affordable health insurance that's available to more people
  2. Expand the Medicaid program
  3. Support efforts designed to lower the overall cost of healthcare

As you head into ACA reporting season, there are a handful of steps and considerations to tackle.

Determining employer status & affordability

The first step in ACA reporting is determining whether your company is an Applicable Large Employer (ALE). That means determining the number of full-time employees as well as full-time employee equivalents (employees who work 30+ hours per week or 120+ hours per month).

To determine the number of full-time employee equivalents OR whether your company is an ALE, follow the simple equations in our ACA E-Book.

Next, determining affordability - but what does that mean? Under the ACA employer mandate, affordable coverage is defined as costing no more than 9.56% of household income. While this is the basic requirement, some employer actions or
contributions can affect determining affordability. Learn more in our e-book.

Employer reporting 

As part of the Affordable Care Act, employers must be able to show they are following the requirements of the law - which initially left many employers scratching their heads as to what reporting the IRS required of them.

Under the Internal Revenue Code sections 6055 and 6056, employers must provide information to the IRS about the health plan coverage they offer (or do not offer) to their employees. 

Our e-book covers the five draft forms included in the Internal Revenue Codes: 1095-B, 1094-B, 1095-C, 1094-C and 1095-A.

Steps and considerations for employers planning ACA reporting 2020

  1. Determine Employer Status
  2. Determine Plan Affordability
  3. Reporting
  4. Complete IRS Forms
  5. Special Cases
  6. Noncompliance

Special cases & employer noncompliance

In addition to status, affordability, IRS forms and reporting, employers should also consider special cases that impact plan affordability and the consequences of noncompliance.

Employer-sponsored wellness plans and payments offered to those who don't opt-in to company-provided health insurance are both scenarios that could affect plan affordability. Additionally, late filings or failure to produce all the required information could lead to costly penalties. Get the full details in our ACA e-book

ACA reporting can be confusing, but it doesn’t have to be! When you partner with
Benefitexpress for benefits administration outsourcing, we help you remain compliant.

Looking for more information on ACA compliance and ACA filing? Check out our exclusive e-book: The Employer's Roadmap to ACA. If you're ready for more, find out how Benefitexpress can help and download our ACA product sheet