Companies grapple with ACA reporting
HEALTH
When they hear mention of the Affordable Care Act, employers in
It's a sigh of frustration and confusion.
For the first time, large businesses and selfinsured small businesses are required to report all employee health coverage information from 2015 to prove they have satisfied health insurance requirements under the ACA.
Businesses that are required to report must provide information that is data intensive, according to
Employees can be categorized with about 10 or so codes in the report, according to
She said that figuring out the right codes to use is the most challenging and time-consuming part of reporting. The codes categorize where employees, spouses and dependents fall under each of the ACA requirements.
"The hardest part is trying to determine if we have the right code filled in for each month for each employee," Ford said.
Stages of compliance
When it comes to where they are in relation to their reporting requirements, employers fall into three categories, Scott said.
First are the employers who know about the required reporting and have the problem solved.
Next are employers who know they have a problem, and are working on it and hoping that everything works out.
The third are those who have no idea the problem is out there.
The
Small businesses, defined as employers with less than 50 employees, are required to report information showing they have satisfied health insurance requirements under the ACA only if they are self-insured. They need to file information on individuals covered under their selfinsured plans.
Businesses with 50 or more full-time employees, or full-time equivalents, are required to report on both: any employees who are covered under their plans, as well as any employees considered full time, as defined by the ACA.
Reporting is slightly different depending on whether the large business is traditionally insured or self-insured.
Local companies keep pace
The first form, known as a 1095-B, must be sent by companies to both employees and the
The second form is known as a 1095-C. This form provides information related to the employer mandate, and reports all employees who were considered full-time at any point in 2015, as defined by the ACA, regardless of whether they were actually offered coverage by that employer in 2015.
If the business is traditionally insured, the insurance company will fill out and send the 1095-B, while the employer is responsible only for the 1095-C.
Small businesses with traditional insurance have no reporting requirements.
Employers have to gather information for each employee hired or employed in 2015 including their names, addresses, dates of birth,
The coverage offered has to be minimum essential coverage, which is any broad-based insurance plan, according to
For instance, if the plan only covers cancer, that would not be minimum essential coverage, but if it covers a variety of treatments, it is.
Once the minimum-coverage requirement is met, the next questions are: Did that coverage meet minimum value and was it affordable?
A minimum-value plan has to provide substantial coverage of inpatient hospitalization and physician services. A plan also has to cover at least 60 percent of a user's medical expenses.
Scott said employers typically meet minimumvalue requirements.
Glus explained that an individual plan is considered affordable according to the ACA if it costs less than 9.5 percent of the covered person's household income. It doesn't matter what the cost is for any dependents added to the plan after that.
"Now that makes it a little easier for us, because we don't have to do a lot of work when determining their eligibility," said
The company handles its payroll in-house, and although it considered looking to an outside vendor for help with the ACA, most vendors were at capacity by September, and likely wouldn't have been able to complete the work in time.
The next step was developing a program in its current software to capture the information needed for the reporting.
Although the
"If we're putting it together for the W-2s, we might as well just file the report," Long said.
Fligh reacted to the deadline extension the same way. Since it had already explained to employees the 1095-B form would come with their W-2s, it was easier to stick to the original deadline than to create confusion, according to Ford.
Payroll for High's 2,030 employees is outsourced, so that company will handle printing and sending the forms.
High still had to collect the data, though, which is housed in one system.
"The hardest part is trying to determine if we have the right code filled in for each month for each employee."
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