Upload
amanda-ericson-sphr-shrm-scp
View
97
Download
0
Embed Size (px)
Citation preview
Affordable Care ActTracking and Reporting
Getting Ready for 2016July 16, 2015
Additions to theInternal Revenue Code
Section 6055 —Individual Mandate
Section 6056 —Employer Mandate
Confirms if individuals have satisfied the
“Individual Mandate.” This section applies to the entity that insures the
coverage.
Determines whether large employers have satisfied
the “Pay or Play” rule. This section applies to
Applicable Large Employers.
IRS Sections 6055 and 6056are about Reporting
To Individuals To The IRS
Via Form 1095-Band/or Form 1095-C
Via Form 1094-B and/or1094-C
pluscopies of the forms
provided to individuals
Non-Calendar Year Plans
• The reporting requirements and filing deadlines do not changefor non-calendar year plans.
• Data for all of 2015 must be captured and reported.
• Section 4980H Transition Relief options
Penalties for Non-Compliance• By 2019, the government expects to collect $25 billion
in penalties from businesses for failures to comply with the ACA
• Penalties for non-compliance are $250 per return, up to $3 million
• Employers who can show a good-faith effort to comply will not be penalized in 2016
Do you have 50 or more Full-time Equivalent employees?
Understanding Employer Obligations
No. Are any of your medical plans
self-insured?
Yes. As an Applicable Large Employer (ALE), you are subject to Section 6056. Are you self-insured?
Yes.You are subject to Section 6055
and will use Forms 1094-B and 1095-B.
No.You are not
subject to the new reporting requirements.
Yes.Self-insured
employers will use Forms 1094-C and 1095-C, Parts
1, 2 and 3.
No. Fully-insured
employers will use Forms 1094-C and
1095-C, Parts 1 and 2 (not Part 3).
Small Employer, Self-Funded Do you have 50 or more Full-time Equivalent employees?
No. Are any of your medical plans
self-insured?
Yes.You are subject to Section 6055
and will use Forms 1094-B and 1095-B.
No.You are not
subject to the new reporting requirements.
Yes.Self-insured
employers will use Forms 1094-C and 1095-C, Parts
1, 2 and 3.
Yes. As an Applicable Large Employer (ALE), you are subject to Section 6056. Are you self-insured?
No. Fully-insured
employers will use Forms 1094-C and
1095-C, Parts 1 and 2 (not Part 3).
What Forms Go Where?For the Self Funded Organization:
IRS
1095 – BProvided by
Employer, for every employee. Sent via
mail – 2/29/16Sent electronically –
3/31/16
1094 – BProvided by the
Employer. Sent via mail – 2/29/16
Sent electronically –3/31/16
Employee
1095 – B Provided by the
Employer. Sent by 1/31/16
1095 – B Line 8 Codes
A. Small Business Health Options Program (SHOP). B. Employer-sponsored coverage. C. Government-sponsored program. D. Individual market insurance. E. Multiemployer plan. F. Miscellaneous minimum essential coverage.
Where is the DataPayroll W-2 and affordability safe harbor
calculation
Time Keeping Service hours for determination of full-time status
Benefits Administration Eligibility, benefit status, dependent information, coverage offer dates, waivers, employees on leave
Questions to AskFact Finding? • What are you doing to help me
with ACA Reporting?• How much does it cost• ARE WE PART OF A CONTROL
GROUPIntegration? • How much time does it take to
implement into our system• Does it integrate into time
keeping, payroll, ben admin?
What does the client need to do?
• Discuss budgets and strategy• Make a decision TODAY
CONTROL GROUPScenario • Vicki’s “I Don’t Know Café” has 30 Full
Time EEs that work 35 hours per week• Vicki’s second business operation “You
Choose Saloon” has 40 Part Time EEs that work 20 hours per week
Work out the Math • 30 – Full Time Employees + 26.6 FTEs (Full Time Equivalents) = 56.6 FTEs • 40 EEs * 20 hr/week / 30 hours (full
time EE hour calculation) = 26.6
FTEs Calculation: • Vicki is an Applicable Large Employer (ALE) and could potentially receive a penalty
• Will help populate and submit reports
• Implementation can take 3 - 4weeks
• Capable of integrating with payroll vendors
• Quote based on size of organization, and how many control groups
• Reasonable costs – comparative of hard vs soft $$
Next StepsJuly/August • Determine what information your payroll vendor
can provide• Engage SyncStream, if needed
September • Pull sample reports from relevant vendors
December • Run reports to collect data from January through November
January • Incorporate December data• Transfer data to IRS forms• Communicate to employees what reporting they
will receive and its purpose
• Utilize Ben Admin/Payroll Reporting function to complete form
February 1 • Distribute Form 1095-B or 1095-C to employees
February 29 or March 31(if filed electronically)
• All 2015 submissions due to IRS
Amanda Ericson, SPHR, SHRM-SCPDirector of HR Compliance Tel: (970) 584-1719 | Mobile: (970) [email protected]
Shirazi Benefits8205 W. 20th St. | Greeley, CO 80634http://www.shirazibenefits.com
Supplemental material supplemented from: Presidio Benefits