In January 2017, an Executive Order was signed to minimize the burden of the Affordable Care Act (ACA) for individuals, families, healthcare providers, insurance providers, patients, recipients of healthcare services, purchasers of health insurance, and makers of medical devices, products or medications. Notice who isn’t on that list? Employers.
With so much uncertainty swirling around the Affordable Care Act, how do businesses know how to proceed?
At this point, the Senate still needs to approve the proposed new health care act that has passed the House - which may be a long process. So, for now, the ACA repeal is stalled and the Affordable Care Act is still the law of the land. That means that as employer, you need to comply or face strict financial penalties.
In fact, the IRS, who oversees reporting and requirements for the ACA, are currently working on penalty notification letters for 2015 noncompliance that will be sent in upcoming months. These letters from the IRS may come as a surprise to many businesses that didn’t comply and will now face stiff penalties. Estimated penalties nationwide may be close to $31 BILLION dollars. See a list of penalty amounts and descriptions here.
How do you avoid penalties moving forward?
- Make sure to offer the appropriate health insurance coverage
- Offer health care coverage exactly when your employee becomes eligible
- Ensure that 1095-C forms are provided to all employees
- Provide 1094-C cover sheet to the IRS
- File on time
Who needs to comply?
Employers with 50 or more FTEs need to comply with the ACA. A full-time equivalent is any employee that works an average of 30 hours per week. If you have many part-time employees, you’ll need to add their total hours worked and divide that number by 30. That will give you the number of FTEs to add to your total.
What do Applicable Large Employers (ALE) need to offer?
ALEs need to provide a group health plan that meets basic specifications for care. This is referred to as Minimum Essential Coverage. The plan also needs to have a Minimum Value of at least a bronze level compared to marketplace offerings. Finally, the plan needs to be affordable. Affordability is defined as no more than 9.5% of a person’s household income.
The bottom line – reporting requirements are not going away. Continue reporting on your health care offerings and employee coverage. Even if the ACA repeal goes through, chances are that the reporting requirements will remain.
Ensure that during 2017 you:
- Track every employee’s hours of service
- Identify which employees are eligible for coverage
- Track each employee’s individual cost of coverage
- Make sure your health insurance meets affordability standards
- Provide 1095-C forms to employees
- File 1095-C form with the IRS
If you’re looking for a software solution for the ACA,