ACAManager - Quick Reference Guide

ACAManager Terminology


Default: 
This is regular employer group with a single company name and employer identification number (EIN).

Control Group: 
Multiple bC4 companies with common ownership and employees that work in two companies at the same time.

Hybrid Control Group: 
Divisions with unique names and EINs that differ from that of the company name, but have common ownership.

Multi-Employer Group: 
Divisions have differing EINs and names, but the only thing shared among the companies are the plans. If the companies did not have the same plans, they would exist as separate companies in bC4.

Federal Poverty Level (FPL):
Cost of employee only level of coverage is less than, or equal to, 9.69% of FPL for 2017.

Look-back Period:
A measurement period to look back at hours worked, to determine if an employee averaged at least 30 hours per week and should be offered benefits. ACAManager will only allow for a 6 or 12 month look-back period.

Minimum Essential Coverage (MEC):
Major medical health insurance plan. Offered coverage must have both “Actuarial Value” of 60% or more, and covers all 10 essential health benefits.

Minimum Value (MV):
Employer offered coverage pays at least 60% of total cost for medical services amongst a standard population. Benefits include substantial coverage of physician and inpatient hospital services.

 

Definitions of ACA Reports


LOOKBACK PERIODS REPORTS

If you have chosen to enter hours into ACAManager and utilize the Lookback Period function, you will reference these reports. Here you can manage employee hours that have been entered to measure and determine eligibility. This report will assist in reviewing Full Time Equivalent (FTE) status per the ACA guidelines. Please note: you will only need to load hours for part time or variable hour employees who are not currently eligible for medical coverage. You do not need to load hours for full time employees who are eligible or enrolled in coverage.

  • Initial Lookback Periods Report – This report can be reviewed monthly to identify variable hour employees that are considered to meet full time equivalent status. The initial Lookback Period Hours Report reflects the running average of all uploaded hours to date.
  • Lookback Periods Report – Based on your designated lookback period, this report will show all employees who have satisfied the FTE requirement and should be offered benefits. In addition, it will display employees who have lost their FTE status and should no longer be benefit eligible.
  • Initial Lookback Periods Hours Report - used to see all hours loaded during a lookback period for employees (6 or 12 months), starting from date of hire.
  • Lookback Period Hours Report - used to see all hours loaded during the lookback period as it applies to the current or upcoming stability period (plan year).

 

DISCREPANCY REPORT (FT/PT)

These reports provide a list of employees with an employee type of “Full-Time” or “Part-Time” in benefitsCONNECT. The data will display any employees that register a discrepancy based on their uploaded hours in comparison to their benefitsCONNECT employee type. This is based on the ACA guidelines and designated threshold of 130 per month. These reports can be run by either “Full-Time” or “Part-Time” status. Example: John Smith = “Part-Time” in benefitsCONNECT, however uploaded hours for March 2017 reflect 185.

 

e-File Status


The e-file section of ACAManager will direct you to the Status page. Here, it will identify the acknowledgement date and your current e-File status. Initially, you will be “In Process” until we receive notification of your submission and determination of whether it was accepted, accepted with errors, or rejected. You may also download the report for ongoing reference if necessary.

 

Decoding the Codes


Form 1095-C (Line 14)

Code What does this code mean? When should this code be used?

1A

You made a Qualifying Offer: You offered Minimum Essential Coverage (MEC) with Minimum Value (MV) to the employee (EE). The offer is affordable because it’s < or = to 9.69% of the single, mainland federal poverty line. You offered MEC to spouse + dependents.

  • You offer coverage to EEs, spouses and children.
  • You offer MEC providing MV.
  • Your coverage is affordable at the employee-only level because it’s < or = to 9.5% of the single, mainland federal poverty line.

1B

You only offer coverage to EEs. The coverage is MEC and provides MV.

  • You exclude spouses + children from your plan.

1C

You offer coverage to EEs that is MEC and MV and offer MEC to EEs children. Spouses are not offered coverage.

  • You exclude spouses from your plan.

1D

You offer coverage to EEs that is MEC and MV and offer MEC to EEs spouses. Children are not offered coverage.

  • You exclude children from your plan.

1E

You offer coverage to EEs that is MEC and MV and offer MEC to EEs spouses and children

  • The only difference between this code and 1A is that your coverage may not be affordable or it is affordable based on a safe harbor other than the federal poverty line.

1F

You offer MEC to the EE or EE + spouse and/or dependents but the coverage does not provide MV.

  • Your coverage does not provide MV.

1G

You offer self-insured coverage to an employee who was not full time at any point in the year.

  • You offer a self-insured plan.
  • Non-full time employees are eligible for your plan.
  • The employee was enrolled in the plan, for this month.

1H

You made no offer of coverage (or one that didn’t provide MEC for the EE).

  • The EE was not yet hired.
  • The EE was in a limited non-assessment period.
  • The EE was otherwise ineligible for coverage.
  • Your offer of coverage was not MEC.
  • Your offer of coverage was not for an entire month.
  • The employee terminated and you offered COBRA.

1I

Qualifying Offer Transition Relief 2015: You did not offer EE + spouse or children coverage, or you offered non-qualifying coverage, or the qualifying offer was for less than 12 months.

  • You made a qualifying offer for one or more months of 2015 to at least 95% of your full-time employees (not counting those in a LNAP).
  • Qualifying offer not made for this month.

Form 1095-C (Line 16)

Code What does this code mean? When should this code be used?

2A

You did not employ this person during the month.

  • The employee (EE) is not yet hired.
  • The EE is no longer employed.

2B

The EE was not full time (FT) for this month.

  • The EE is part time.
  • The EE is seasonal or variable hour.
  • The EE is in a measurement period and his/her FT status is not yet established. (See Code 2D)

2C

The EE enrolled in the coverage you offered.

  • The EE accepts and enrolls in your offer of coverage.
  • *If you have an option between 2C and another code, use 2C.

2D

The EE was in a Limited Non-assessment Period (LNAP) for the month.

  • The EE is in a waiting period under the Monthly or Look-Back measurement method.
  • The EE is in an initial measurement period under the Look-Back method.
  • The EE is in the first calendar month of employment and did not start on the first day of the month.
  • It is your first year as an applicable large employer (ALE).
  • The EE has a change in status during his/her initial look-back measurement period.

2E

You are eligible for the multiemployer interim relief rule.

  • Some portion of your workforce is eligible for a multiemployer (union) plan.
  • You make an ongoing contribution to the plan on behalf of union EEs.

2F

The coverage you offered is affordable based on the Form W-2 safe harbor.

  • Coverage is affordable for this EE based on the W-2 safe harbor method.
  • You used the W-2 safe harbor for every month that the EE is offered coverage.

2G

The coverage you offered is affordable based on the Federal Poverty Line safe harbor.

  • Coverage is affordable to this EE based on the federal poverty line safe harbor method.

2H

The coverage you offered is affordable based on the Rate of Pay safe harbor.

  • Coverage is affordable to this EE based on the rate of pay safe harbor method.

2I

You are eligible for non-calendar year transition relief for this month, which applies to this EE.

  • You offer a non-calendar year plan and are eligible for associated transition relief.
  • This EE was only eligible for a non-calendar year plan.
  • You can’t use this code if the EE is also eligible for a calendar year plan you offer.

Topics: ACAManager