ACA Module User Guide WFL (New UI)

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Adding an ACA Profile:

When an employee is hired, you will need to assign an ACA Profile. Currently the default date will be listed as  01/01/2012, this is hard coded in the system and does not need to be updated as a new hire. 

 

Standard ACA Profiles

  • Not Applicable- A non eligible employee, temp, or 1099
  • Full Time EE- Full Time Employee, no hours need to be measured
  • Variable Hour/Part Time EE- Employee who has variable hours and their time needs to be measured. 

 

To add an ACA Profile For New Employees:

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  1. From your Dashboard, select Employee Changes > Hire an Employee 
  2. Select the ‘ACA profile’ in the Other Settings section
  3. Leave the ‘Effective Date’ as 1/1/12image1.png

To update an ACA Profile For Existing Employees:

(i.e. Employee went from Temp to a Hired Employee or EE was offered a Permanent Full Time Position )

  1. From your Dashboard, select Employee Changes > Other Employee Changesimage17.png
  2. Select theimage20.png icon to open the Employee Information screen
  3. Go to the ‘ACA’ tab and scroll down to the ACA Timeline Overview sectionimage16.png
  4. Select the link Manage Employee’s ACA Timeline, then click image12.png to add a new record for ‘ACA Profile’ with the appropriate effective date. 

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5. If employees should be continually measured for FTE (Full Time Equivalent) ACA status year after year, the ‘Variable Hour/Part Time EE’ ACA Profile should remain 

image24.png6. Select image8.png in the top right to update the ACA reports with this new profile



Reviewing the ACA Tab at the Employee Information Level:

 

ACA Summary Widget

This widget shows a summary view of rules contained within the employee’s ACA profile. 

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ACA Employee Status Change History Widget

Here additional Rehired or Terminated dates can be manually recorded. Select image5.png on the right to add any additional dates not displaying. By default, these settings will display what is listed on the employee’s Dates section of their profile.


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ACA Timeline Widget

A short overview of the ACA reporting is available here, or you can click Manage Employee’s ACA Timeline to review more data outlined below

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Status widget:

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Hours – Represents the hours worked by the employee during the given calendar month. These hours can be configured to populate automatically from timesheets or pay statements. Alternatively, these hours can be imported or manually edited.

 

Month Status – Represents if the total hours in the given month are above the FT (full-time) threshold. If so, the system returns a status of FT. If the hours are below the FT threshold the system then returns a status of PT (part-time). This threshold is defined in the employee’s ACA profile by using one of the following rules: Calculate Monthly Hours From Timesheets, Calculate Monthly Hours From Payroll, or Monthly Hours Imported or Manually Added.

 

When a Standard and Initial measurement period ends, the resulting status (FT or PT) will be reflected in the next new month and will reflect through the end of the stability period or until a new status resulting from the next measurement period is generated, whichever comes firs t. The employee’s next upcoming ACA status is reflected during the next administrative period after the end of a measurement period (even if it is still not the end of a previous stability period).

 

 ACA Status – Represents the status that the employee is currently in based on the completed prior measurement period. This is calculated based on the average number of hours worked in the last measurement period. The Calculate Status ACA rule will populate these fields within the ACA Timeline.



Measurement widget:

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Waiting Period Month – Applies to non-variable hour employees. If a waiting period is configured within the ACA profile, the month number (1, 2, or 3) will appear in this row of the ACA Timeline.

 

Initial Measurement Month – For newly hired employees who are still in their initial measurement period, the months (1-12) will be tracked in this row of the ACA Timeline. There is only ONE initial measurement period per employee. Once ended, a new one does not begin.

 

Initial Administrative Month – For employees who have just completed their initial measurement period, if an administrative period is configured in the ACA profile then the months (1 or 2) will be tracked in this row of the ACA timeline.

 

Initial Stability Month - For employees who have completed their initial measurement month and (if applicable) their initial administrative month, the stability period will continue onward and be tracked on this row of the ACA Timeline.

 

Standard Measurement Month - The standard measurement period is defined as a timeframe that repeats over and over for all employees assigned to the same ACA profile. This can run concurrently with an initial measurement period, if it applies.

 

Standard Administrative Month - Lists the number of months (1 or 2) selected for the Administrative Period within the profile.

 

Standard Stability Month - Lists the number of months selected for the Stability Period (1-12) within the profile.

 

Alerts widget:

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Affordable Plan Offered- If benefits are being tracked in the application, the ACA profile can be configured with a rule which will determine if an employee was offered an affordable health plan based on any of the available safe harbor calculation methods during the given month shown in the ACA Timeline. If they have been offered a plan, a Yes will display in this field. If they have not been offered a plan, a No will display.

 

Minimum Value Plan Offered – If benefits are being tracked in the application, the ACA profile can be configured with a rule to check if a minimum value plan was offered to the employee during any given month shown in the ACA Timeline. If they have been offered a plan, a Yes will display in this field. If they have not been offered a plan, a No will display.

 

Compliance Alert – If an employee was NOT offered an affordable plan or a minimum value plan, a compliance alert is then shown as Yes in this field and the month header will display the compliance alert symbol (the exclamation mark within a gold triangle.) If there are no compliance alerts for a given month, then No will display in this field.

 

Approaching ACA FT - Based on the configuration in the ACA profile, this column will indicate with a Yes or No if an employee who is currently PT (part-time) may be approaching a possibility of working enough hours to become considered FT (full-time) in the near future.

 

Possible Downgrade - Based on the configuration in the ACA profile, this column will indicate with a Yes or No if an employee who is currently FT (full-time) may be approaching a possibility of working less than the average hours to become considered PT (part-time) in the near future.

 

1095-C Line 14 Codes (Series 1)- As defined by the IRS guidelines.

 

Limited Non Assessment Period- This will display a “Yes” when any of the following are true:

  • The employee is in a waiting period
  • The employee is in an initial Measurement or initial Admin period
  • It is within the 1st calendar month they are hired, if hired any day other than the 1st
  • It is within the period following a change in status up to 3 full calendar months

 

1095-C Line 15 (Monthly Share Lowest Cost )- The Employee’s share of the monthly premium, of the lowest cost plan for employee only, offering  minimum value coverage.

 

1095-C Line 16 Codes (Series 2)- As defined by the IRS guidelines.

 

Click image10.png  on the date headings over each column to have an additional window ACA Rule Debug Information displaying details of the calculation methods used and how the values were obtained. This information can be key to understanding why a given month calculated the ACA values the way it did.

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The data can be manually recalculated at any time by clicking image2.png  in the top right, then selecting which year you want to recalculate from

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If any changes are made to the ACA Profile, Benefit Profile, or the Benefit Plan, the employees affected by ACA  need to be recalculated. This can be done at a Mass Level by selecting the hamburger menu icon image15.png  in the top left then navigating to Team > Benefits > ACA > Employee ACA Actions. Select employees with the checkbox on the left, then click image2.png in the upper right corner.

 

ACA Reports

Reports are available to view ACA specific data under Team > Benefits > ACA (Affordable Care Act).

Employee ACA Actions

Displays all employees and their assigned ACA Profile, allowing you to recalculate, clear, and import their historic data. A link to view each employee’s ACA history is available, as well as links to the two other reports in the system (upper-right corner.)

ACA Data Detailed

This report displays each employee and their detailed ACA history for the selected date range. Data is displayed as one row per employee with each ACA item displayed in the columns. 

ACA Data Summary

This report displays total amounts for the selected date range within each affected ACA field. To view the employees included within the totals, click the blue numbers to display a report

 

Custom Reports- Delivered with payroll. 

  • Initial Measurement Period Completed Report (Only applicable with Variable Hour Employees)- This report will show you employees who have completed the Initial Measurement Period and will now be in the Initial Admin Period. Columns to pay close attention to are the “Average Hours in Measurement Period” and the “ACA Status”. These columns will show you if the employee averaged 130 hrs or more a  month and if they were deemed FT. For Multi EIN clients, you will need to review the column “Employee has Other person Account”. If “Yes” is listed in this column. You will need to note the employee’s name and run the following report.
    • Multi EIN Average  Hours- This report will sum the total hours for ALL EIN’s. You need to filter by the employee’s first and last name. Under the column “EIN AVG HRS” you will see the average hours for all entities. 
  • Compliance Alert Report-This report will show you if any employees have a  compliance alert for the month.  Columns to pay close attention to are the Affordable Plan Offered and Minimum Value Plan Offered. These columns should be populated with Y (Yes) in order to be in compliance with ACA.

 

Notifications- Email will be sent to the contact if applicable to the client (Has Variable Hour Employees)

 

  • ACA Status Changed- Status changes from FT to PT or PT to FT

 

  • ACA Benefits Enrollment- When the ACA Status changes to FT and an offer of benefits needs to be made to the employee 

Reference Guide for ACA Codes

SECTION 6056 REPORTING CODE DESCRIPTIONS FOR THE 1095-C

Use this guide to aid in completing Form 1095-C. Most commonly used codes are bolded  Part II, Line 14 

(What Medical Benefit Did You Offer the Employee?)

Code

Description

1A

A plan meeting the “minimum value” requirements was offered to this full-time employee with
employee contribution for self-only coverage equal to or less $101.79/month in 2020 (9.69% in 2017, 9.56% in 2018, 9.86% in 2019, 9.78% in 2020)  and at least minimum essential coverage was offered to this employee’s spouse and dependent children. You will use this code if using the Federal Poverty Level Affordability Safe Harbor for this particular employee. This is also known as a “qualifying offer.”

1B

A plan meeting the “minimum value” requirements was offered to this full-time employee only, but
not to this employee’s spouse or dependent children. It’s rare, but some companies do not allow any dependents to enroll on the plan. This would be the code companies that do not allow dependents to enroll in the plan would use.

1C

A plan meeting the “minimum value” requirements was offered to this full-time employee and at least

minimum essential coverage was offered to this employee’s dependent children, but not to this employee’s spouse. This code would be used for most spousal carve-out plans if coverage is not offered to the employee’s spouse.

1D

A plan meeting the “minimum value” requirements was offered to this full-time employee and at least

minimum essential coverage was offered to this employee’s spouse, but not to this employee’s

dependent children. This one would be very, very rare.

1E

A plan meeting the “minimum value” requirements was offered to this full-time employee and at least minimum essential coverage was offered to both this employee’s dependent children and spouse. This will be the most frequently used code. So if the company is not planning to use the Federal Poverty Level Safe Harbor and offered coverage to this full-time employee and their family members, this would be the correct code.

1F

Minimum essential coverage NOT providing minimum value offered to employee, employee and

spouse and/or employee, spouse and dependent children. This could be a “skinny” or “mini” health

plan that meets the threshold for minimum essential coverage, but not for minimum value.

1G

An offer of coverage was made to this employee who was not a full-time employee for any month of

the calendar year and who enrolled in self-insured coverage for one or more months of the calendar year. You would only use this code if the company sponsors a self-funded plan and allows a part-time

or non-employee to enroll, so this one is rare. This code should always be placed in the “all 12 months”

box if selected.

1H

This employee received no offer of health coverage. Or, this employee received an offer of health

coverage that fails to meet minimum essential coverage requirements. This code is used for any month that the employee did not work for you, when the employee was in their waiting period or when the employee was working part-time hours and ineligible for health insurance.

1J

This code is only used when the company only allows some employees to add their spouse, but not other employees. So this code is used when working spouses or spouses with other coverage are not eligible for the plan. Therefore, use this code if the employee is offered minimum essential coverage providing minimum value but such coverage is only offered to certain spouses (with conditions) and is not offered to dependent children. This one is very rare.

1K

This code is only used when the company only allows some employees to add their spouse, but not other employees. So this code is used when working spouses or spouses with other coverage are not eligible for the plan. Therefore, use this code if the employee is offered minimum essential coverage providing minimum value but such coverage is only offered to certain spouses (with conditions) and is offered to dependent children. This one is also very rare. The only difference between this one and IJ is whether or not coverage is offered to dependent children. IK is used when it is offered to dependent children and IJ is used when it is not. 

  

Part II, Line 15 ((How much did the offer cost the employee?)

Complete line 15 only if code 1B, 1C, 1D, or 1E is entered on line 14 either in the “All 12 Months” box or in any of the monthly boxes. You do not report the actual amount the employee paid for coverage on this line. Rather, it is asking for the employee share of the monthly premium for the lowest cost, self-only minimum value coverage. It’s very possible the employee selected a more expensive plan or opted to cover dependents, so only report the amount it would have cost the employee if the employee had selected “employee-only” coverage for your least expensive plan option that meets the minimum value requirements.

Part II, Line 16

“What did the employee do when the offer was made?” 

OR “Why was the offer not made?”

Code

Description

2A

This employee was not employed on any day of the calendar month. Do not use this code if they were employed on any day in the month. For example, if the employee only worked a partial month because this was the month in which they were hired or terminated, do not use this code. This code will most commonly be used for new hires and employees terminated during the calendar year.

2B

The employee is not a full-time employee for the month and did not enroll in minimum essential
coverage, if offered for the month. This is also the code to use if an employee terminates in the middle of the month and coverage is not extended through the end of the month. This does not apply to employees who are in their waiting period or measurement period.

2C

This employee was enrolled in the employer’s plan every day of this calendar month. Whether the spouse or dependents are enrolled has no effect on this code. This code will be the most common and if this code applies to the employee, it should supersede any other code that may also apply for this line.

2D

Enter code 2D for any month during which an employee is in a Limited Non-Assessment Period, such
as a waiting period or measurement period.

2E

Enter code 2E for any month for which the multiemployer interim guidance applies for that employee.

2F

The employer used the W-2 Affordability Safe Harbor for this employee for the year. If an employer uses this safe harbor for an employee, it must be used for all months of the calendar year for which
the employee is offered health coverage. This code is most commonly used when an eligible employee waives coverage and the employer uses the W-2 Affordability Safe Harbor.

2G

The employer used the Federal Poverty Level Affordability Safe Harbor for this employee for any
month(s). This code is most commonly used when an eligible employee waives coverage and the employer uses the Federal Poverty Level Safe Harbor. This code generally is used in conjunction with Code 1A in Line 14.

2H

The employer used the Rate of Pay Affordability Safe Harbor for this employee for any month(s). This
code is most commonly used when an eligible employee waives coverage and the employer uses the
Rate of Pay Affordability Safe Harbor.

 

* The most common codes are bolded and underlined.