Go ahead and consider yourself a super broker because you’re checking off all their boxes.
The time has come once again — the beginning of a new year kicks off with the Affordable Care Act (ACA) season. You’ve been entrusted to manage benefits all year long, now it’s time to shine by saving your clients time and money. The 2023 ACA filing season is no small task as penalty fees of up to $290 per form loom and good faith relief ends. Become the ACA hero for your clients and set them up to avoid costly mistakes.
Understand the fundamentals of ACA.
Remember: not all of your clients will be subject to ACA reporting. Only your applicable large employers (ALEs) and employers of any size offering self-funded group medical plans are required to report coverage information. On top of that, depending on the state, your employers may be required to file on a state level, as well. We’re looking at you — California, Massachusetts, New Jersey, Rhode Island, Vermont, and the District of Columbia.
Now, how do you determine which reports need to be filed for your employers? We’ve got you covered. ALEs need to file a 1094-C form and 1095-Cs for each full-time and full-time equivalent (FTE) employee. While self-funded plans file a 1094-B or C form and 1095-Bs or Cs for all covered employees.
Upcoming dates to remember.
Mark your calendars, we’ve rounded up all the dates you need to remember this year. If you’re planning to file by mail to the IRS, February 28th is the last day. Though, if you’re filing electronically using Ease’s partnership with Nelco — the deadline is extended to March 31st to submit all forms to the IRS. And don’t forget about your employees. Provide copies of all 1095 forms to full-time employees and covered individuals either by hand, mail, or electronically by March 2nd.
Let’s dive deeper into ALEs.
Applicable large employers (ALEs) should be top-of-mind when it comes to ACA. Companies with 50 or more full-time equivalent employees in the previous calendar year are required to file.
These employers must offer minimum essential coverage to at least 95% of full-time employees and their dependents each month. This offered coverage needs to provide the minimum value and be affordable to all full-time employees. For medical coverage to be considered affordable, it should not exceed a certain percentage of the employee’s household income or one of the affordability safe harbors.
You’ll want to write these percentages down:
- If the plan year begins in 2021, the percentage is 9.83%.
- For plans beginning in 2022, the affordability percentage is 9.61%.
Keep an eye out for these common mistakes.
Mistakes, errors, missteps, blunders. There are a ton of variations of this word, but you don’t want to hear any of them when completing ACA reporting. One mistake could cost your employers a lot of money in fines. As you get started on generating your ACA forms, watch out for these common errors as reported by Benefit Comply.
- Failure to mark yes on form 1094-C, Part III, Column (a).
- Failure to use 1H or 1__ for all months on form 1095-C, line 14.
- Failure to properly code waiting periods and initial measurement periods.
- Failure to list the correct employee contribution on form 1095-C, Line 15.
- Failure to use affordability safe harbor codes on form 1095-C, line 16.
- Failure to report self-funded coverage for COBRA participants and retirees.
Watch now: Arm yourself with the information you need for a successful 2023 ACA reporting season with our on-demand webinar hosted by Benefit Comply.
Skip the headache — make ACA simple this year.
Benefits plans are built in Ease, employees have completed enrollments, and employee information is already filled out. Now, groups can stay compliant and implement ACA with Ease. You and your groups can calculate their applicable large employer statuses, measure healthcare affordability, generate IRS-mandated 1094 and 1095-B and C forms, and track eligibility for variable-hour employees all within Ease.
Believe it or not — it only gets better from there. We’ve partnered with Benefit Comply to help you and your employers review reporting and avoid costly errors. Ease users can connect with a consultant today.
It’s never too late to make ACA easier.
Activate ACA with Ease in your Marketplace to save time, avoid errors, and spare your groups from hefty penalty fines.