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Affordable Care Act (ACA) Reporting Requirements: Employer s Guide to Meeting Filing Deadlines & Ensuring Compliance FEATURED FACULTY:

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Affordable Care Act (ACA) Reporting Requirements: Employer s Guide to Meeting Filing Deadlines & Ensuring Compliance FEATURED FACULTY: Mark Schwartz, Employment Tax Specialist Mark
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Affordable Care Act (ACA) Reporting Requirements: Employer s Guide to Meeting Filing Deadlines & Ensuring Compliance FEATURED FACULTY: Mark Schwartz, Employment Tax Specialist Mark Schwartz, Employment Tax Specialist Mark Schwartz is an employment tax specialist and has over 10 years of employment tax experience as an independent consultant and as a payroll tax auditor with the State of California. He has managed an audit caseload of 20 ongoing audits, from small home-based businesses to large multi-national corporations. He is expert at defining regulatory and statutory requirements from local, State and Federal government agencies; and helping the average businessperson understand what that mean to their business. **Certificates of attendance and CEUs, when available, must be requested through the online evaluation.** Evaluation for Live Event: We d like to hear what you thought about the audio conference. Please take a moment to fill in the survey located here: Requirements-Employer-s-Guide-to-Meeting-Filing-Deadlines-Ensuring-Compliance Requests for continuing education credits and certificates of attendance must be submitted within 10 days of the live event. HRCI Receive 1.25 recertification credit hours toward PHR and SPHR recertification through the Human Resource Certification Institute (HRCI). For more information about certification or recertification, please visit the HRCI homepage at The use of this seal is not an endorsement by the HR Certification Institute of the quality of the program. It means that this program has met the HR Certification Institute s criteria to be pre-approved for recertification credit. EMPLOYER REPORTING REQUIREMENTS UNDER THE AFFORDAB LE CARE ACT Mark Schwartz, MBA Owner, MS Payroll LEARNING OBJECTIVES 1} Overview of reporting requirements 2} General Reporting Method 3} Alternative method 4} Third party and Multi-Employer plans 5} 1094C and 1095C forms 1 2017 EXECUTIVE ORDER 1} Does not change ACA on its own it Directs agencies to start the process of repeal and replace, while making certain choices allowable within the ACA itself, and within existing law. 2} There is a current lawsuit filed by the House of Representatives stating the Administration lacks authority to pay subsidies required under the Act. If Trump Admin does not defend themselves.. 3} The Act provides for hardship exemptions on individual mandate. EO directs agencies to examine and widen scope for these exemptions EXECUTIVE ORDER 4} EO wants all lawsuits settled expediently, and waivers granted more liberally. 5} If 1 and 2 take place, expect the program to face serious funding issues, and pressure for premiums to increase for all health insurance plans. 6} Employers should not expect immediate substantial changes to their requirements. The goal of the Trump admin is to repeal and replace eventually. 2 CHANGES FOR } Higher penalties for high income individual tax payers who are uncovered. 2} Insurance Companies must provide 30 day notices to employers before network providers are removed. 3} Some changes to Out-of-Network Costs 4} Penalties increase for employers who do not comply 5} Copies of forms 1095-B and 1095-C must be provided to employees y Jan 31. Forms must be submitted to IRS by 2-28 (paper), 3-31 (electronic) I. OVERVIEW Final Regulations issued as Treasury Decision 9661 on March 10, 2014 Section 6056 of the Code applies to employers that are applicable large employers (ALEs) ALEs are employers with at least 50 fulltime employees (employees having an average of at least 30 hours of service per week), including full-time equivalent employees Exemption for military health coverage including TRICARE or veterans coverage. 3 I. OVERVIEW Although ALE status is determined combining employers with common ownership and treating them as a single employer, liability under section 4980H applies on an ALE member by member basis. An ALE member is any person or persons that comprise the ALE Each ALE member must file required information returns with the IRS and furnish a copy to each individual who was a full-time employee of the ALE member for one or more months of the calendar year I. OVERVIEW - FORMS Form 1094-C, Transmittal of Employer Provided Health Insurance Offer and Coverage Information Returns - Transmittal of Employer Level Data. DUE 2/28/16, extended to May 31 (6/3 if filed electronically. Form 1095-C, Employer Provided Health Insurance Offer and Coverage Employee Statement Due to employee by 1/31/16, extended to 3/31/16. 4 I I. GENERAL R E P O RTING M E T H O D Full Reporting for all full-time employees Reporting on a month-by-month basis: To whom coverage was offered (employee, spouse, and dependents) Lowest cost monthly premium for self-only coverage providing minimum value Indicator codes will be used to report certain other information I I I. A LT E R N AT I V E R E P O R T I N G M E T H O D S 1} Qualifying Offer Method Employer certifies that a qualifying offer was made to one or more full-time employees The qualifying offer must: Be an offer of minimum essential coverage providing minimum value at an employee cost for employee-only coverage not exceeding 9.5% of the mainland federal poverty level and include an offer of at least minimum essential coverage to the employee s spouse and dependents, if any. 5 I I I. A LT E R N AT I V E R E P O R T I N G M E T H O D S 1} Qualifying Offer Method{cont } If employer can certify a qualifying offer was made to one or more employees, then for those employees for whom a qualifying offer was made for all 12 calendar months the employer may report as follows: A Form 1094-C with employer level data A Form 1095-C with an indicator code to show a qualifying offer was made, OR a statement to the worker that they are ineligible Full reporting required for full time employees not covered for all 12 months I I I. A LT E R N AT I V E R E P O R T I N G M E T H O D S 1} Qualifying Offer Method{cont } - Transition Rule for 2015 For 2015 only, full reporting will not be required for employees who do not receive a qualifying offer for all 12 calendar months if the ALE Member: certifies that it made a qualifying offer to at least 95% of its fulltime employees for at least one month of the year and Files Form 1094-C Files Form 1095-C using an indicator code to report whether the employee received a qualifying offer, or the qualifying statement 6 I I I. A LT E R N AT I V E R E P O R T I N G M E T H O D S 2} 98% Offers Reporting ALE Members are still required to report for all full-time employees If the employer does not want to determine who their full-time employees are per month The employer can certify that it offered coverage to at least 98 percent of the employees on whom it reports under section 6056 The coverage offered must be affordable minimum essential coverage providing minimum value The employer is then not required to report the number of fulltime employees per month. I V. 3 R D PA R T Y A N D M U LT I - E M P L OY E R P L A N S Third parties and multiemployer plans are permitted to facilitate filing and furnishing returns for ALE members Liability for section 6056 reporting or information reporting penalties is not transferred to the third party or the multiemployer plan Liability for the section 4980H provisions remains with the ALE member If the third party or multi-employer is a tax return preparer, the normal return preparer rules apply 7 V C A N D C F O R M S 1094-C (Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns: Employer Name, Address, EIN, and contact information # of 1095-Cs submitted ALE Member Information V C A N D C F O R M S 1095-C (Employer-Provided Health Insurance Offer and Coverage): Employee Name, TIN, and contact information Employer Name, EIN, and contact information Offer of coverage (by month) Covered Individuals 8 F O R M C 9 N O T E : P A R T I V I S O N L Y F O R A M E M B E R O F A N A G G R E G A T E D A L E M E M B E R G R O U P ( E. G., C H E C K S Y E S O N L I N E 2 1 ) 10 11 LINKS 12
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