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3 ACA Reporting Alternatives

3 ACA Reporting Alternatives Unraveled

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For many organizations, the employer mandate and the reporting requirements of the Affordable Care Act (ACA) loom. Employers want to ensure they will be in compliance come January 2016, when the required forms are due to their full-time employees and the Internal Revenue Service.

Yet many organizations remain confused by the law’s many complexities, especially those related to the reporting provisions. In fact, two-thirds of business executives who have attended Paycom’s ACA webinars in the past four months reported they are not ready to comply with the 2015 reporting requirements!

As staggering as that statistic is, it is important that organizations understand options exist for ACA reporting. You might be surprised to learn which method is best suited for your organization.

Who’s Set to Report?
Starting this year, Applicable Large Employers (ALEs) – organizations with 50 or more full-time or full-time-equivalent employees – will be held to the mandatory filing, which reports the details of health coverage offered to those employees.

The ACA’s “general reporting” method is completing, in its entirety, IRS Form 1095-C, Employer-Provided Health Insurance Offer and Coverage Insurance. This form must be filed with the IRS for every employee determined to be full-time for at least one month during the calendar year. Additionally, employers must provide either a copy of Form 1095-C or an alternate statement to affected employees by Jan. 31 of the year following the year the insurance was offered.

In an effort to simplify reporting requirements in certain situations, the IRS now allows three optional alternative methods:
1. The Certification of Qualifying Offer
2. The Simplified Statements for 95 Percent Offer
3. The 98 Percent Offer

The Certification of Qualifying Offer
This states that in lieu of Form 1095-C, eligible employers are allowed to certify that they extended a “qualifying offer” of health care coverage to employees, as long as the offer provided minimum essential coverage to them, their spouses and dependents, and that the cost of the coverage did not exceed 9.5 percent of the federal poverty level for employee-only coverage.

This report will include the name, address and Social Security number of each full-time employee, along with the indicator code of “1A” from line 14 of Form 1095-C. This code signifies that the employee received a qualifying offer for all 12 months; no other details are required.

The information provided to employees through either a copy of the Form 1095-C or a general statement in a format “prescribed by the IRS” must state that:

1. the employees (plus any spouse and/or dependents) received a qualifying offer for all 12 months of the year
2. and therefore, they generally are ineligible for a premium tax credit for all of those 12 months.

Most employers wishing to use this alternative method will have to furnish a mixture of simplified and general reports to their workers and the IRS, as not all employees will have been with the company for the full, 12-month span.

However, it is important to note that organizations will not know until the end of the year whether simplified reporting can be used for any individual employee; therefore, it is important to maintain records of ACA-required data – affordability, minimum coverage offered and employee full-time status – in order to ensure compliance.

The Simplified Statements for 95 Percent Offer
Available for 2015 only, this alternative allows certain employers to provide a “general statement” in lieu of filing Form 1095-C. They must certify on Form 1094-C that they have made qualifying offers to at least 95 percent of their full-time employees, their spouses and dependent(s).

The information provided to employees through a “general statement” must be in a format “prescribed by the IRS” and must state that:

1. the employees (plus any spouse and/or dependents) received a qualifying offer for all 12 months of the year
2. and therefore, they generally are ineligible for a premium tax credit for any of those 12 months.

These statements may vary, depending on whether the employee received a qualifying offer for all, some or none of the months. Thus, if the qualifying offer did not apply to an employee for the entire 12 months, the statement likely will inform them that any of the aforementioned entities may be eligible to claim a premium tax credit for any month in which a qualifying offer was not made.

Additionally, the statements must supply a contact name — which can be a member of the ALE or a third-party administrator — and telephone number, should an employee wish to call for additional information.

The 98 Percent Offer
For employers who offer qualifying coverage to at least 98 percent of their full-time employees, this third reporting alternative is available. It does not excuse them from submitting Form 1095-C, but does allow them to bypass two data points on Forms 1094-C and 1095-C:

  • the month-to-month full-time status of employees
  • and the monthly total of full-time employees.

Employers who offer coverage to “substantially all” of their full-time employees may lessen the burden on themselves to track and record hours of service in order to identify the number of full-time employees for each month. Because Form 1094-C appears to require reporting of members ranked by full-time employees, it isn’t clear whether or not this option is possible for aggregated groups.

Are the General Statements Useful?
For many, the general statement may cause more confusion than it’s worth; it may be simpler for employers to distribute a copy of Form 1095-C.

Also, it is possible that taxpayers may need to enter information from Form 1095-C on their year-end personal income tax returns, so those receiving the general statement may have to contact their HR department to obtain that information. While the IRS has not yet given guidance on the format of these statements, the bureau does require both an employer contact name and phone number for verification purposes.

The Simplified Ending
In closing, the simplified reporting alternatives may prove useful for a number of organizations, but a lot remains up to the interpretation of the law and each business’ ability to anticipate if it will be eligible to use these alternatives. If you are among the two-thirds of businesses not ready to comply with the 2015 reporting requirements, it is in your best interest to talk to a Paycom representative today.

The content of this blog is intended to keep interested parties informed of legal and industry developments for educational purposes only.  It is not intended as legal opinion or tax advice and should not be regarded as a substitute for legal or tax advice.



Author Bio: A writer, speaker and young business leader, Jason has been the communications pulse for a number of organizations, including Paycom. A featured writer on human capital management technology, leadership and the Affordable Care Act, Jason launched Paycom’s blog and social media channels, helping empower organizations around the nation. Jason is attuned to the needs of businesses and recently helped develop a tool to aid organizations in their pursuit to comply with the ACA; one of the largest changes in healthcare the country has seen. While working in athletics for ESPN and FoxSports, Jason learned the importance of hard work and branding. In his free time he enjoys adventuring with his family, reading and exploring new areas to strengthen his business acumen.

ACA Awaits Repeal or Repair

ACA Awaits Repeal or Repair

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ACA Awaits Repeal or Repair

After his electoral win in November, President Donald Trump, buoyed by Republican majorities in the House and the Senate, vowed to act quickly to repeal and replace the Affordable Care Act (ACA). Pres. Trump has now been in office for a month, and Republicans have not yet voted to repeal the ACA, and have not agreed upon a potential replacement, leaving the date of “repeal and replace” somewhere in the uncertain future. stethoscope

Early strategies

When the current Congress convened in January, it moved quickly to begin the “repeal” portion of “repeal and replace” by passing a budget resolution. Because the GOP does not have a filibuster-proof majority in the Senate and cannot count on votes from Democrats to repeal the ACA, Republicans have decided to utilize a procedure known as budget reconciliation to dismantle it.

By using this procedure, Congress can pass a bill to repeal the ACA with a simple majority in the Senate. The reconciliation instructions in the budget resolution directed various committees to come up with proposals to repeal the ACA and submit them to the budget committees of the House and Senate. The reconciliation proposals would then be crafted into a bill by the budget committees, and the reconciliation bill would then need to pass both the House and the Senate before being signed by the President.

Potential outcomes

However, the provisions of the bill passed this way must target elements of the ACA that have a federal budgetary effect. Therefore, the ACA provisions that allow children to stay on their parents’ insurance through age 26 and the requirement that insurers cover preexisting conditions could not be eliminated using this procedure. Nor could the individual and employer mandates be eliminated in this way, but the amounts of the penalties could be reduced to zero, eliminating them in all but name.

Repeal or repair?

Republicans originally called for reconciliation proposals to be submitted to the budget committees by January 27, but that date has come and gone. Congressional Republicans continue to work on “repeal and replace,” but many of them have begun talking about “repair” of the ACA, rather than repeal, as they recognize the difficulty of legislating in this area.

In an interview with Fox News’ Bill O’Reilly on February 5, President Trump said that replacement could take until 2018.

O’Reilly asked “Can Americans in 2017 expect a new health care plan rolled out by the Trump administration this year?”

Trump responded, “We’re going to be putting it [the new healthcare plan] in fairly soon, I think that … by the end of the year at least the rudiments but we should have something within the year and the following year.”

Employer mandates remain in place

One thing that has become clear during the first month of the Trump presidency is that repealing the ACA is a much tougher prospect than many had thought. Despite the uncertainty with regard to the long-term future of the ACA, the current reality is that the ACA and the employer mandate remain the law of the land, and employers should continue to comply with the law’s requirements. Applicable Large Employers should file IRS Forms 1094 and 1095 no later than the March 31 if filing electronically, or February 28, if filing paper forms. Forms 1095-C must be furnished to employees no later than March 2. Large employers should continue to comply with the employer mandate, measure their full-time employees, and offer minimum essential coverage providing minimum value to those employees and their dependents.

Paycom will continue to monitor executive and Congressional action regarding the ACA closely and stands ready to help our clients maintain compliance.

 

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Posted in ACA, Blog, Compliance, Featured

Erin Maxwell

by Erin Maxwell


Author Bio: As a compliance attorney for Paycom, Erin Maxwell monitors legal and regulatory changes at the state and federal level, focusing on health and employee benefits laws, to ensure the Paycom system is updated accordingly. She previously served as assistant general counsel at Asset Servicing Group in Oklahoma City. She holds a bachelor’s degree from the University of Central Oklahoma and a J.D. from the University of Oklahoma. Outside of work, Maxwell enjoys politics, historical mysteries and spending time with her family.

6 Compliance Changes to Check in 2017

6 Compliance Changes to Check in 2017

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Compliance Deadlines and Issues to Watch in 2017

Employers can expect developments  in 2017 related to the Fair Labor Standards Act (FLSA), the Affordable Care Act (ACA), Equal Employment Opportunity Commission (EEOC) requirements and several other workplace regulations concerning compliance. Here’s a closer look.

 

  1. Fair Labor Standards Act

On Nov. 22, 2016, Judge Amos L. Mazzant III of the U.S. District Court for the Eastern District of Texas issued an injunction delaying the effective date of the new overtime rule. The rule would have raised the minimum salary threshold for exempt executive, administrative and professional employees to $913 per week, from $455 per week and the minimum annual salary threshold for highly compensated employees to $134,004, from $100,000.

How long the injunction will remain in place – and the fate of the rule – is anyone’s guess. Meanwhile, employers should adhere to current FLSA requirements and keep an eye out for the outcome of the Department of Labor’s current appeal.

 

  1. Affordable Care Act

Although the leadership in the House of Representatives currently is attempting to repeal ACA, for now, employers still remain responsible for all ACA tracking and reporting requirements. The deadline for issuing ACA forms 1095-B and -C to employees has been extended from Jan. 31, 2017 to March 2, 2017. However, the due date for filing ACA forms with the Internal Revenue Service (IRS) is unchanged. For 2016 tax year, applicable large employers must:

  • Submit paper forms 1094-B and -C and 1095-B and -C by Feb. 28, 2017

 

  • Submit electronic forms 1094-B and -C and 1095-B and -C by March 31, 2017

 

The IRS has extended the “good faith effort” penalty waiver to 2017. Employers who submit inaccurate or incomplete reporting information may be relieved from penalties, as long as they can show they made a “good faith effort” to comply with the ACA’s requirements.

Note that although the 40-percent “Cadillac” tax on high-cost employer health plans has been delayed until 2020, employers should consider assessing the impact of the tax on future business goals now. Once the impact is understood, a feasible strategy can be put in place.

 

  1. Equal Employment Opportunity Reporting

The EEOC has revised the Employer Information Report (EEO-1) to include collecting pay data from employers, including federal contractors, with over 100 employees.

Under the original proposal, employers would submit their annual EEO-1 report – which would include W-2 pay data and hours worked – to the Joint Reporting Committee by September 30 of each year. However, the EEOC has issued an updated proposal that would move the due date for the 2017 report from Sept. 30, 2017 to March 31, 2018. In subsequent years, the deadline will be March 31.

Be sure to monitor the revisions to the EEO-1 report, and prepare a strategy for implementation in case the changes are enacted.

 

  1. Citizenship and Immigration Services Reporting

U.S. Citizenship and Immigration Services recently updated Form I-9. After Jan. 21, 2017, employers must start using the new form.

 

  1. Minimum Wage and Paid Sick Leave

Many states, cities and counties have approved minimum wage increases and mandatory paid sick leave, some of which will take effect in 2017.

 

  1. Federal Contract Workers

The minimum wage for federal contract workers increases to $10.20 per hour Jan. 1, 2017. Certain federal contractors also must provide their employees with up to seven days of paid sick leave per year.

Staying ahead of potential and actual regulatory changes is easy with an HR and payroll system that generates the necessary forms and enables electronic filing to simplify reporting. It’s also important to partner with an HR technology provider who stays abreast of tentative regulatory matters and quickly updates their system accordingly, so that you have the right tools for any changes.

 

DISCLAIMER: The information provided in this blog is for general informational purposes only. Accordingly, Paycom and the writer of the above content do not warrant the completeness or accuracy of the above information. It does not constitute the provision of legal advice, tax advice, accounting services, or professional consulting. The information provided herein should not be used as a substitute for consultation with professional tax, accounting, legal or other professional services.

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Posted in ACA, Blog, Compliance, Featured, FLSA

Heidi Lively

by Heidi Lively


Author Bio: Heidi Lively serves as Paycom’s Additional Business Manager, where she focuses on the compliance and service of additional business products. Previously, she served customers in the Paycom Service Department where she quickly rose through the ranks to earn a team leader position. Having performed in a leadership position for a number of years, Heidi has been able to cultivate and influence others through Paycom’s leadership initiatives. Heidi earned her bachelor’s degree from the University of Central Oklahoma.

Reimbursement: Small businesses can now reimburse employees who purchase their own health insurance

Small Businesses Can Now Compensate Employees Who Purchase Their Own Health Insurance

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Small Businesses Can Now Compensate Employees Who Purchase Their Own Health Insurance

New, small employer ACA requirements effective for plans beginning after Dec. 31, 2016

President Barack Obama recently announced a small gift for small businesses as it relates to insurance. Title 18 of the new 21st Century Cures Act, signed by President Obama on Dec. 13, 2016, allows small employers the use of Health Reimbursement Arrangements (HRAs) to compensate employees who buy their own health insurance for themselves and their families.

Reimbursement Amounts

Maximum annual benefits for the individual are $4,950 or $10,000 a year for families. Employers are to report the total amount of benefits received on their employees’ W-2 forms, beginning with the 2017 calendar year. After 2016, the above dollar amounts are subject to annual cost-of-living increases.

Reimbursement Details

The reimbursements are for the cost of employee health insurance plans purchased through the Affordable Care Act (ACA) marketplace or on the individual market, effective after Dec. 31, 2016. Reimbursements only can be funded by the employer, and cannot include employee salary reduction contributions. The employee’s out-of-pocket plan must provide for the payment or reimbursement of medical care expenses that are incurred by the employee or the employee’s family members and the employee must provide proof of health coverage to their employer. HRAs must be offered on the same terms to all eligible employees, but employers may exclude from eligibility employees who have not completed 90 days of service, have not reached age 25, part-time or seasonal employees, employees included in a collective bargaining agreement and employees who are non-resident aliens who have no earned income derived from sources within the U.S.

Notice Requirements

Small employers must give an annual notice to eligible employees:

  • at least 90 days before the start of the year, or,
  • at least 90 days before the employee’s initial eligibility date, or
  • no more than 90 days after the legislative enactment of the 21st Century Cures Act; whichever is later.

 

The annual HRA notice must:

  1. state the amount of the employee’s permitted benefits
  2. educate the employee on how to disclose the reimbursement amount to any health insurance exchange if an employee chooses to apply for the premium assistance tax credit
  3. warn about taxes that may be charged if the employee does not have minimum essential coverage each month
  4. remind the employee that the HRA may be included in Gross income

 

If the business fails to follow the above requirements, it will be subject to a $50 per-employee per-incident penalty, up to $2,500 per calendar year, unless the failures were due to reasonable cause and not willful neglect.

This HRA Isn’t for Every Employer

The 21st Century Cures Act created a new type of HRA called the “qualified small employer HRA” (SEHRA). The IRS code does not consider SEHRAs as group health plans, therefore making them unqualified for the excise tax levied on group health plans that don’t meet the ACA market reform requirements. If your company is considered an applicable large employer and/or has at least 50 full-time or full-time equivalent employees then you are not eligible to provide a SEHRA.  Additionally, you cannot provide an SEHRA if you offer a group health plan to any of your employees.

DISCLAIMER: The information provided in this blog is for general informational purposes only. Accordingly, Paycom and the writer of the above content do not warrant the completeness or accuracy of the above information. It does not constitute the provision of legal advice, tax advice, accounting services, or professional consulting. The information provided herein should not be used as a substitute for consultation with professional tax, accounting, legal or other professional services.

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Posted in ACA, Blog, Featured, Tax Credits

Heidi Lively

by Heidi Lively


Author Bio: Heidi Lively serves as Paycom’s Additional Business Manager, where she focuses on the compliance and service of additional business products. Previously, she served customers in the Paycom Service Department where she quickly rose through the ranks to earn a team leader position. Having performed in a leadership position for a number of years, Heidi has been able to cultivate and influence others through Paycom’s leadership initiatives. Heidi earned her bachelor’s degree from the University of Central Oklahoma.

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