Are you keeping up with the ACA?

Answer a few simple questions to find out if you're keeping up with ACA regulations —
and discover how much blind spots might cost you.

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ACA Compliance Quiz

1

Applicable Large Employer (ALE)

How many people do you employ full-time?

1 5,000


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Why it matters
If you have at least 50 full-time employees (including full-time-equivalent employees), you are considered an Applicable Large Employer (ALE) according to the Affordable Care Act (ACA) and must offer full-time employees health care coverage or pay a penalty.

2

ACA Full-Time Employee Definition

Do you consistently define full-time employees based on the ACA definition of 30+ hours across all your HR policies?

Yes   No

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Why it matters
There is a discrepancy between HR policies and ACA definition of what determines a full-time employee so alignment of policy, procedure and system definitions are paramount.

3

Monthly Full-Time Employee Status

Are you confident you’re accurately calculating monthly full-time status for employees under the ACA?

Yes   No

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Why it matters
There are penalties for failing to offer coverage to full-time employees as defined under the ACA.

Potential Penalty:
$2,000–$3,000 per employee (starts after first 30 employees for applicable companies). Please note the penalty amount is indexed by the IRS.

4

ACA Eligibility

In 2016, will you offer health coverage to at least 95% of your full-time workforce?

Yes   No

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Why it matters
In 2016, transition relief ends. Employers with 50 or more full-time employees must offer minimum essential coverage that is affordable and provides minimum value to full-time employees or potentially pay a penalty.

Potential Penalty:
$2,000–$3,000 per employee (starts after first 30 employees for applicable companies). Please note the penalty amount is indexed by the IRS.

5

Affordable Minimum Value Coverage

Do you offer affordable health care coverage that provides minimum value to your full-time employees?

Yes   No

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Why it matters
Employers with 50 or more full-time employees must offer minimum essential coverage that is affordable and provides minimum value. Affordable coverage means that an employee’s premium contribution for self-only coverage for the lowest cost plan does not exceed 9.66% of employee’s household income in 2016 (affordability safe harbors apply). Minimum value means a plan would pay for at least 60% of medical expenses on average for a standard population.

6

Affordability and Wellness

Do you offer wellness program or other employer incentives and understand how employer contributions affect affordability?

Yes   No

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Why it matters
Employer contributions may need to be taken into account for purposes of calculating the amount of each employee’s share of the lowest-cost, self-only coverage. All of these can either positively or negatively affect the affordability:

• Employers Contributions to HRA
• Employer Flex Credits Under Cafeteria Plans
• Employer Opt-Out Payments
• Wellness Program Incentives

7

Form W-2 Reporting

If you issue 250 or more W-2s, do you include the cost of group health coverage provided to employees?

Yes   No   Doesn't apply to me

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Why it matters
Employers that issued 250 or more Forms W-2 must include the cost of group health coverage provided to employees on Form W-2 in Box 12, Code DD.

Potential penalty:
Penalties can be up to $260 per incorrect/incomplete return for returns filed to IRS and up to another $260 per incorrect/incomplete return furnished to the employee.

8

Forms 1094-C and 1095-C

Do you have access to all data required to complete annual health care reporting?

Yes   No

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Why it matters
Annual Health Care reporting is more complex than W-2 reporting, because it requires data from up to four different systems (HR, Payroll, Benefits and Leaves) and includes a series of calculations, rather than mapped data.

9

1095-C Employee Communications

Are you effectively communicating to your employees about Form1095-C?

Yes   No

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Why it matters
Proactively and effectively communicating to your employees about Form 1095-C can help drive down the number of calls you receive, and reduce the questions and requests for re-runs to your organization.

10

Notice of Coverage Options

Do you provide your employees with a notice describing the availability of public Marketplace Exchange coverage?

Yes   No

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Why it matters
Employers must provide new employees with a notice describing availability of public Marketplace Exchange coverage within 14 days of the employee’s start date.

11

Marketplace Notices

Do you have a process for managing inbound Marketplace Notices?

Yes   No

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Why it matters
You'll receive a Marketplace Notice if any of your employees apply for coverage through an Marketplace Exchange and are deemed eligible for a premium tax credit. Best practice is for employers to review and appeal the notice with the Marketplace Exchange within 90 days, if applicable. You may be able to minimize the penalty for your organization and/or mitigate the financial risk facing the associate who may have incorrectly received a premium tax credit.

12

Results

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