The affordable care act (aca)

The Affordable Care Act (ACA)

 

The Affordable Care Act was created to make health insurance affordable & available to more people in the United States. The law provides consumers with subsidies (“premium tax credits”) that lower costs for households with incomes between 100% and 400% of the federal poverty level (FPL). ACA protects people with preexisting conditions from discrimination and has led to better access to care and health outcomes for low-income individuals and their families across the country.

On October 2, 2020, the IRS announced extending the deadline for employers to provide employees with a copy of their 1095-C or 1095-B reporting form, as required by the ACA, from January 31, 2021, to March 2, 2021. In addition, the IRS again extended “good-faith effort” transition relief to employers for the plan year 2020 reporting. The deadlines were not extended for filing 1095 forms with the IRS, and they are still February 28 for paper filing or March 31 for electronic filing.


The Affordable Care Act or ACA Reporting Codes

 

The Affordable Care Act or ACA reporting codes are complicated and, if done incorrectly, can result in fines to your organization. ACA reporting service provides affordable solutions for employers who are required to comply with the Affordable Care Act (ACA) Reporting requirements. 

Why HR Service for ACA Reporting?

We make sure everything is 100% accurate, eliminate the hassles of doing it yourself, are reasonably priced, and guarantee on-time completion. If adjustments are needed, we can make needed corrections. 

The Affordable Care Act (ACA) Services

If you are looking to simplify the process of ACA reporting, we can help. We offer a wide range of resources and services designed to make your life easier.

1094 & 1095

We will create the required 1094 & 1095 documents or any other documents needed.

Letter 226-J

We can help if you receive letters from the IRS on past reporting errors, letters 226-J.

Choose Your Filing Method

We give you the option to E-File with the IRS or Mail to employees.

Series Codes Determined

We Determine 1 & 2 Series Codes on your behalf.

We Make ACA Simple

All you need to do is work with your assigned ACA Expert, who will ask for necessary information, then complete the reporting for you. You have the option to either mail forms yourself or to have us take care of them.

Dedicated ACA Analyst

Your assigned analyst performs stress-free document collection. They are here to ensure you are safe from future potential IRS problems.

ACA FAQ

1094-C and 1095-C: Employers with 50+ employees will need to use these forms to report both fully insured and self-insured plans. Once completed for each employee, they must be submitted to the IRS using submittal form 1094-C.

1094-B and 1095-B: Employers with fewer than 50 employees who provide employer-sponsored self-insured health coverage will use forms 1094 & 1095-B. Click here for 1094-B and 1095-B IRS instructions.

 

ALEs also are subject to the employer shared responsibility payment provisions. You may have to make a shared responsibility payment if at least one full-time employee receives the premium tax credit for purchasing individual coverage through the Health Insurance Marketplace and you:

    • failed to offer coverage to at least 95 percent of full-time employees and their dependents, or
    • offered coverage to at least 95 percent of full-time employees but not to the particular full-time employee receiving the credit (one of the 5 percent), or
    • offered coverage that was not affordable, or 
    • offered coverage that did not provide a minimum level of coverage.

ACA Reporting must also be completed by employers who average less than 50 FT/FTE employees but are self-insured or level-funded. This is because the IRS considers the employer as the insurer and therefore the 1094/1095 B Forms must be submitted each year to show which employee and each of their dependents were covered by health insurance the year prior.

 

Are you an ALE?

 

Find out by downloading our ALE Calculator.

  • ACA Reporting for ALEs and Self-Funded Plans – 6055 and 6056 Reporting.
    $280 for each filing failure for filings made in 2021 (penalty indexed for inflation each year). Total penalty amount cap of $3,392,000 for 2021 filings.
  • ACA Notices (e.g., Patient Protection Notice, Rescission of Coverage Notice).
    $100/day for each individual for whom the failure applies if the failure is not corrected within 30 days of knowledge.

 

ACA Employer Mandate
Applicable Large Employer’s (ALEs) may face penalties if:

  • Do not provide minimum essential coverage (MEC) to substantially all (95%) full-time employees.
  • Penalty for not offering coverage to substantially all full-time employees equal the ALE’s number of full-time employees (minus 30) multiplied by 1/12 of the annual $2,700 penalty amount for 2021 for any applicable month.
  • Do not offer coverage to full-time employees that is the affordable or minimum value (MV).

 

The penalty amount for each full-time employee who was not offered affordable, MV coverage is 1/12 of the annual $4,060 penalty amount for 2021 for any applicable month that a specific employee receives a subsidy through an Exchange. This total penalty amount is limited to the penalty amount for not offering coverage to substantially all full-time employees. Potential penalties are triggered only if one or more full-time employee obtains a subsidy through an Exchange.

 
The premium tax credit is an income-based subsidy available to help people pay for private health insurance. It was introduced as part of the Patient Protection and Affordable Care Act (ACA) and provides assistance to individuals who earn up to 400% of the federal poverty level ($45,960 for an individual).
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