ACA Forms Instructions ver .92
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2016<br />
<strong>ACA</strong> IRS Compliance<br />
Kenneth F. Phillips<br />
Benefit Corporation of America, LLC.<br />
www.benefitscape.com<br />
508.655.3307
Introduction<br />
Thank you for providing the necessary data needed to prepare your <strong>ACA</strong> IRS filing for 2015.We<br />
are confident that the codes we have calculated for the IRS Form 1095C accurately reflect the<br />
data you have provided.<br />
The next step is for you to review the results that we have determined based on your data. By<br />
“review” we propose that you look o<strong>ver</strong> the data for accuracy and completeness.<br />
What we need you to do next<br />
There are PDF forms in your Sharefile 1 with the information to review. You should<br />
download the PDF forms and look them o<strong>ver</strong>. <strong>Instructions</strong> are on the next page.<br />
What we have done to insure accuracy and completeness<br />
Step 1.<br />
Disco<strong>ver</strong>y<br />
We have taken all of the plan rules, company data and applied the <strong>ACA</strong><br />
IRS rules to your Organization.<br />
Step 2.<br />
Processing your<br />
Data<br />
We have taken your employee data, tested its accuracy and processed all<br />
of the data to determine which employees are to be reported to the IRS.<br />
Step 3.<br />
Producing your<br />
Reports<br />
The employee data is then processed by our systems to produce the<br />
‘results’ required by the IRS. These results are printed onto the Form<br />
1095C and prepared for publishing and mailing to each employee.<br />
These are the FORMS that you have to review<br />
After you have reviewed the forms you should communicate your<br />
comments to us. We will make the necessary corrections (if any are<br />
needed) and Print and Mail the <strong>Forms</strong> to your employees.<br />
Congratulations! Your compliance effort for 2015 is complete.<br />
1 If you do not know how to get access to your Share Folders please send us an email and we can help. y<br />
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How to review your forms<br />
The first item to review for accuracy is that the Company information is correct.<br />
Next step, please review the various codes.<br />
Step 1. <strong>Forms</strong><br />
Review<br />
This is a 2 step<br />
process<br />
1. Check the<br />
Company<br />
Information.<br />
Make sure the<br />
phone number is<br />
correct!<br />
2. Review the<br />
OFFER codes for<br />
each employee.<br />
These are the possible OFFER Codes:<br />
<br />
<br />
1A or 1E means an offer of co<strong>ver</strong>age was made<br />
1H means no offer of co<strong>ver</strong>age was made<br />
The Safe Harbor codes are the reasons or the result for a certain offer.<br />
We determined these codes based on your employee data and plan rules.<br />
Additional common codes are:<br />
2C indicated the employee took the OFFER and has co<strong>ver</strong>age in the<br />
months shown.<br />
2F, 2G 2H indicate employee waived the offer and has no co<strong>ver</strong>age in the<br />
months shown.<br />
2A indicates the employee was not hired at the company.<br />
A complete listing of all the Codes that are available and their explanations are<br />
included in the Appendix attached to this document.<br />
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For Self Funded Plans (Not Fully Insured)It is necessary to show co<strong>ver</strong>age for<br />
each individual by month, check to see if the data appears correct.<br />
If any corrections are needed<br />
In addition to the above; we have provided you with a Spreadsheet with all of the Codes<br />
calculated for each employee (including any dependent information for each employee,<br />
if that information was required.)If you have any corrections you can highlight the errors<br />
on this Spreadsheet and put it back into the Sharefile. Then send us an email and we<br />
will set up a webinar or phone call.<br />
Remember: If the data contains personal information i.e. SSN do not send via email.<br />
Save and upload on the Secure Citrix Sharefile.<br />
If it’s all OK<br />
Send us an email and let us know you are ready for us to publish the <strong>Forms</strong>.We will<br />
then -<br />
Print the <strong>Forms</strong> for each person,<br />
Mail them to each employee’s address provided in the data<br />
The follow up…After the forms are mailed, some may come back for bad address,<br />
or there may be questions on the information.<br />
The best way to handle this is by email (if no personal information is involved).<br />
If you have certain information that is confidential please place it in the Secure Citrix<br />
Sharefile and send us an email explaining the situation.<br />
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Appendix<br />
IRS Form 1095-C - Line 14 - Offer of Co<strong>ver</strong>age Codes Lines 14, 15, and 16<br />
Offer of co<strong>ver</strong>age codes should not be confused with the whether the employee<br />
accepted the co<strong>ver</strong>age. The code indicates that you as the employer provided an “offer<br />
of health co<strong>ver</strong>age to the employee” and is not affected by the employee acceptance of<br />
the offer or if the employee rejects the offer (a wai<strong>ver</strong>).<br />
We have entered an offer of co<strong>ver</strong>age for all 12 months if the employee was a<br />
full-time employee for one or more months during the year.<br />
VERY IMPORTANT - Regarding using codes 1A through 1F, the co<strong>ver</strong>age offered must<br />
be applied to e<strong>ver</strong>y day of the month. If the offer is less than for a full month codes<br />
1A/1E should NOT be used. If the employee only worked part of the month, then the<br />
only codes that should be used is 1H (No Offer).<br />
Situation<br />
MEC providing MV offer made to employee,<br />
dependents, and spouse.<br />
MEC providing MC offer made to employee only.<br />
MEC providing MC offer made to employee and<br />
dependents (not spouse).<br />
MEC providing MC offer made to employee and spouse<br />
(not dependents).<br />
MEC providing MC offer made to employee,<br />
dependents, and spouse, but cost is more than 9.5% of<br />
po<strong>ver</strong>ty line.<br />
MEC providing MC offer made to employee,<br />
dependents, and spouse, but no minimum essential<br />
value.<br />
MEC providing MC offer made to employee who was not<br />
a full-time employee for any month during the year and<br />
enrolled in co<strong>ver</strong>age for one or more months.<br />
No offer of co<strong>ver</strong>age.<br />
Quality Offer Transition Relief - Employee and spouse<br />
or dependents received no offer of co<strong>ver</strong>age, received<br />
an offer that is not a qualifying offer, or received a<br />
qualifying offer for less than 12 months.<br />
Offer of Co<strong>ver</strong>age Code<br />
1A<br />
Common<br />
1B<br />
Uncommon<br />
1C<br />
Uncommon<br />
1D<br />
Uncommon<br />
1E<br />
Common<br />
1F<br />
Uncommon<br />
1G<br />
Uncommon<br />
1H<br />
Common<br />
1I<br />
Uncommon<br />
MEC = Minimum essential co<strong>ver</strong>age<br />
MV = Minimum value<br />
Other Situations: Employee terminated and offered COBRA co<strong>ver</strong>age - Use 1H<br />
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IRS Form 1095-C - Line 15 - Employee Share of Lowest Cost Monthly Premium,<br />
for Self- Only, Minimum Value Co<strong>ver</strong>age<br />
Complete Line 15 only if code 1B, 1C, 1D, or 1E is entered on Line 14. The amount entered<br />
is the cost you would charge the employee for self-only co<strong>ver</strong>age providing minimum<br />
essential co<strong>ver</strong>age providing minimum value. This amount may NOT be the amount the<br />
employee is actually paying for co<strong>ver</strong>age, for example, if the employee enrolled in family<br />
co<strong>ver</strong>age and is paying $ 110 a month, but the amount that would be charged for selfco<strong>ver</strong>age<br />
only is $ 90, you would enter $ 90 on line 15.<br />
VERY IMPORTANT - An entry on line 16 is optional. We enter the appropriate<br />
code to fully describe the enrollment to the employee. Balnks tend to confuse<br />
and look like errors.<br />
Situation<br />
Employee not employed during month<br />
Employee not a full-time employee for<br />
the month and did not enroll in<br />
co<strong>ver</strong>age offered or employee was a<br />
full-time employee and co<strong>ver</strong>age ended<br />
before the end of the month because<br />
the employee terminated employment.<br />
Employee enrolled in co<strong>ver</strong>age offered.<br />
Employee in an assessment period and<br />
not eligible for co<strong>ver</strong>age.<br />
4980H Safe Harbor<br />
Code<br />
2A<br />
2B<br />
2C<br />
2D<br />
Use<br />
employees not yet<br />
employed<br />
Common<br />
Uncommon<br />
employees who take<br />
co<strong>ver</strong>age<br />
Common<br />
in waiting period<br />
Common<br />
Multi employer interim rule relief. 2E Uncommon<br />
W-2 earnings used to determine<br />
affordability - code must be used for all<br />
months that the employee was offered<br />
co<strong>ver</strong>age.<br />
Federal po<strong>ver</strong>ty line used to determine<br />
affordability.<br />
2F<br />
– Line 14 will<br />
probably be 1E<br />
2G<br />
- Line 14 will be 1A<br />
For wai<strong>ver</strong><br />
Common<br />
For wai<strong>ver</strong><br />
Common<br />
Rate of pay used to determine<br />
affordability.<br />
Non-calendar year transition relief.<br />
2H<br />
- Line 14 will be 1E<br />
2I<br />
For wai<strong>ver</strong><br />
Common<br />
Non calendar plans<br />
Uncommon<br />
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