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(541) 687-4799

Are you compliant with ACA guidelines?

  • By:
  • Alliance Insurance Group
  • |
  • Jul. 6th, 2016

With 2016 being the first year for Affordable Care Act (ACA) reporting, it will be important that your business is compliant with reporting guidelines. The following ACA compliance checklist details some key points you should be aware of as you navigate the reporting process.

1. Know whether the mandates apply to your company size. The Affordable Care Act mandates that, in 2016, if your business has 50 or more full-time employees, referred to as an Applicable Large Employer (ALE), you'll need to offer minimum essential health insurance coverage to at least 95% (up from 70% in 2015) of those full-time employees to avoid paying a penalty. The IRS defines a full-time employee as one who works at your organization for a minimum of 30 hours per week or whose service hours equal at least 130 hours a month for more than 120 days in a year. Note that if you employ part-time employees, they can collectively be counted as an ‘equivalent full-time employee’ if their hours combine to equal more than 30 hours a week.

2. Make sure to have documented proof that you offered coverage to your eligible full-time employees, and its value. Document essential information, including dates of coverage and whether or not an employee waived their coverage to instead buy via the Health Insurance Marketplace. Keeping this information organized and catalogued, will help you when filling out 1094-C and 1095-C forms to demonstrate ACA compliance.

3. File 1095-C and 1094-C forms. In order to comply with reporting measures, you’ll need to file a 1095-C form for each full-time employee, and a 1094-C form which provides aggregate information about your organization and its coverage as a whole. You can find more information on the purpose of these forms by consulting the IRS brochure Getting Ready: Monthly Tracking.

4. Provide employees with 1095-C form to complete their tax return. Generally, ALE members are required to provide a copy of the 1095-C form to employees so that they have access to information about the coverage they were offered that year when filing their tax returns.

Although there are many moving parts to ACA reporting, if you follow the instructions outlined by the IRS, you can successfully demonstrate compliance. For further information, consult Questions and Answers about Information Reporting by Employers on Form 1094-C and Form 1095-C or Instructions for Forms 1094-C and 1095-C.

For assistance in navigating the complex world of insurance regulations and reporting, contact an Alliance Insurance Group specialist.