Sonoma County Office of Education

ACA Reporting 2016 Affordable Care Act

Presenters: Marie White and Tracy Lehmann 12/8/2016

2016 ACA Review Page 1

Affordable Care Act (ACA)

Based on The Affordable Care Act of 2010, employers with 50 or more FTE (full-time equivalent) must offer coverage to full-time employees and dependents. IRS defines full-time employees work an average of at least 30 hours per week (130 hours) in a calendar month. Employers must provide an annual return reporting the health insurance that is offered to employees. In addition, they are subject to the Employer Shared Responsibility provisions. The IRS required forms are 1095-B and 1095-C. ACA Reference: https://www.irs.gov/affordable-care-act/employers Insurers, self-insuring employers, other coverage providers, and applicable large employers now have

until March 2, 2017 to provide Forms 1095-B or 1095-C to individuals, which is a 30-day extension from

the original due date of January 31, 2017.

https://www.irs.gov/pub/irs-drop/n-16-70.pdf

Electronic filing is due March 31, 2017 and will be submitted by SCOE IT.

Escape 16.04 Release – ACA Changes – Available in mid-Decmber

***IRS Extended ACA to March 2, 2017***

2016 ACA Review Page 2

ACA Checklist – Setup in Escape

Organization Record

Review Section 10 – ACA Setup

□ ALE (Applicable Large Employer 50 FTE or More) = Yes

□ Verify that the W2 Address and contact information are correct

□ If changes needed in Org Record, send request to helpdesk@scoe.org

Bargaining Unit

□ Review ACA Bargaining Unit for employees not covered by a BU

□ Review ACA Defaults Tab

□ Review Look Back Periods Tab (Only needed for ACA BU)

Benefit Groups/Providers

□ Review MED and OPT Out groups

□ Review Benefit Providers have Group Codes

Employee Management

□ Add ACA to Employee if NO Assignment

□ Benefit Provider Tab - Use Coverage Dates for prepaid or retroactive dates

Addons

□ Review Addons that are flagged to Affect ACA Hours

□ Review “Lump” Sum addons for the Number of ACA Hours, as needed

Reports

□ Run the Pay60 ACA Measurement Period Report

□ Review the data for accuracy and qualification of hours for benefits

Employee ACA

□ Load the ACA information into the Employee ACA activity

□ Check Problems, review and resolve

□ Review the data for accuracy

FINAL ACA Employee List Due February 10, 2017

□ Employee ACA List for only those receiving Form 1095-C

Export list to Excel with total number of forms, submit to helpdesk@scoe.org

2016 ACA Review Page 3

Review ESCAPE ACA Setup

Organization Record

Review that your District is setup for ACA if you are an ALE Appicable Large Employer with 50 FTE or more. Verify that the contact information is up to date. The Org record is based on user permissions, for changes send a request to helpdesk@scoe.org .

Go to System Setup - Organization Record Section 9 – W2 Overrides

Must have Employer and Contact information completed, this is default for ACA or go to Section 10 if there is a differenct contact for ACA Reporting.

Section 10 – ACA Setup

ALE - Set the flag to YES if the District is considered an ALE

Self Insured - Horicon District Only

Prepay Benefits - Set the flag to YES if District prepays benefits the month before coverage begins

2016 ACA Review Page 4

Review Bargaining Units

Go to HR/Payroll - Setup - Assignment - Bargaining Units

ACA Default Tab Update existing bargaining units ACA Default Tab

ACA Reporting has two methods: Monthly and Look-back

Monthly – Used with set work hours and set schedule Fill out the ACA Default tab only

Look-Back – Used for hours that are variable Fill out both the ACA Defaults and the ACA Look-back Period tabs

From - Enter the beginning effective dates for Benefit Provider rates. This determines when this provider/level has the specified benefits cap and coverage reporting parameters.

Thru – Use End Date of rates changes. Leave blank until cap amount changes.

MEC Provider - Minimum Essential Coverage Use the lookup to define the benefit provider for reporting the MEC Provider. Must be maintained to avoid the fee and be in compliance with the shared responsibility requirement.

MEC Level - Use the lookup to define the benefit provider level for reporting the MEC. This can be the level with the lowest premium amount for self-only coverage.

ACA Benefit Cap - Enter amount to be paid by employee for the lowest-cost monthly premium for self-only. Example if no cost to the employee than this field should be 0.00.

Offer of Coverage Default - Use the lookup to select from options as define by the IRS. The coverage offered to the employee, spouse and dependents, if any.

Code 1A – Qualifying Offer – Minimum Essential Coverage providing minimum value offer to full-time employee with employee contribution for self-only coverage equal to or less than 9.5% mainland single Federal Poverty line at least MEC offered, as well as MEC offered to spouse and dependents.

2016 ACA Review Page 5

Safe Harbor Default - Use the lookup to select from options as define by the IRS. This is the default for reporting the Safe Harbor method you are using for determining if coverage is considered affordable.

Coverage Waiting Period - Enter the number of months an employee of this bargaining unit

must wait before benefit coverage is offered.

Minimum ACA FTE - Enter the minimum FTE that will define employees with FTE equal to or greater that the number entered as full time. Example enter .75 FTE if this is the minimum for your District.

Example: Teachers are defined as .75 FTE, yet the teachers are considered full time. In this case, you would enter .75 in the Minimum ACA field for the teacher's bargaining unit.

Example: The number of hours worked is the sole factor for determining full time. Teachers are defined at 1.0 FTE, but work 7 hours. In this case, you would leave the field blank so that only the number of hours worked would be considered when determining full time status.

Example: Same as above, but you want 1.0 FTE/ 7 hours to be considered full time. In this case, you would enter 1.0 as the minimum FTE for the bargaining unit.

Determining Full-Time Employees for Purposes of Shared Responsibility for Employers Regarding Health Coverage (§ 4980H) http://www.irs.gov/pub/irs-drop/n-12-58.pdf

2016 ACA Review Page 6

Review ACA Look-Back Periods Tab only needed for ACA BU Under the look-back/stability period safe harbor method, an employer would determine each employee’s full-time status by looking back at a defined period of not less than three but not more than 12 consecutive calendar months, as chosen by the employer (the measurement period), to determine whether during the measurement period the employee averaged at least 30 hours of service per week.

Add Measurement Period for to cover each calendar year Measurement Start - Enter the date the measurement period started Measurement Months - Enter the number of months in the measurement period Admin Months, Stability Months and Measurement End automatically populate

Add ACA Bargaining Unit to Employees

Now that the ACA Defaults and ACA Look-Back Period are defined, it's time to add the bargaining unit to the employee. This field is used when the employee does NOT have an assignment. Reminder: If an employee terminates mid year, than the ACA BU must be added to the employee record or this will be a “Problem” in the Employee ACA List.

Go to HR/Payroll - Employment - Employment Management

Recommendation: Add the ACA BU to all employees, this does not affect the assignment BU and will ensure that the employee is covered by a BU for the entire calendar year. This is also one less step to remember when they terminate.

2016 ACA Review Page 7

Benefit Groups Go to HR/Payroll - Setup - Benefit - Benefit Group Review: The MED and OPT Benefits groups need to be established for ACA In addition, the Benefit Groups are designed for organizations that annualize benefit costs. The group allows you to group providers (e.g., Medical, Vision, Dental) so that when an employee changes providers during open enrollment, Escape can determine how much was paid to each provider and recalculate rates for the rest of the year.

MED Group - Benefit Provider Group that begins with MED for employees who have medical

coverage. This groups medical providers together

MED Post Tax – A new MED Group is needed to add to Benefit Providers that are post tax if Districts have employees with both pretax and post tax benefit providers.

OPT Group - Benefit Provider Group that begins with OPT for employees who have opted out and declined medical coverage.

2016 ACA Review Page 8

Benefit Providers Go to HR/Payroll - Setup - Benefit - Benefit Providers Review: The MED and OPT Benefits Groups must be added to Benefit Providers. MEDPOST Benefit Group must be added to Districts if employess have both pretax & post-tax benefits.

If MED or OPT Group not added to Benefits Providers and records are locked, you will need to send a request to helpdesk@scoe.org with a list of Benefit Providers and the name of the Group Code.

2016 ACA Review Page 9

Benefit Provider Tab

Go to HR/Payroll - Employment - Employment Management

Add the benefit to the employee record

Use the Coverage Begin Date to show the employee actual start of benefits. This would be used for prepaid benefits of if an employee needed to be retroactive for benefit start date. This is for ACA only, does not adjust payroll deductions or contributions.

Dependents Tab

Go HR/Payroll - Employment - Employment Management It’s highly recommended that Dependents with Medical Coverage be added to the employee record, but it’s only required for Self-Insured Districts (Horicon District Only) If dependents were already added to the employee records, they can now be flagged for Medical Coverage by

changing the Medical field to YES.

2016 ACA Review Page 10

Addons – Flag to Affect ACA Hours

Go to HR/Payroll - Setup - Payroll - Addons

Addon Hours are determined to be active in the month based on the year/month of the adjustment.

Hours for Addons are included in the calculations only if the Affect ACA Hours flag is set to YES.

If it is set to YES, the number of hours is based on the Rate 1 Option:

H {Use an hourly rate} - Uses the units for the pay adjustment

D {Use a daily rate} - Uses the hours per day for the position or the hours per day for the

Addon. Defaults to 8 hours per day

Locked (L), position pay (P), base pay (B) or blank - Uses the entry in the Number of ACA Hours

field.

If Rate 1 option is “Locked” this does not calculate for ACA Hours.

It’s best to use hourly or daily, which means a salary schedule should be used as well.

NOTE: If the addon has negative units, those hours will reduce the hours for ACA

2016 ACA Review Page 11

ACA Measurement Period Report This report helps to determine eligibility for benefits and used as an audtit for Employee ACA Activity. When checking for benefit coverage Pay60 report and the ACA load activity, the system will first check the Benefits Provider Tab for Coverage Begin Date and Coverage End Date if they exist, if they do not, then it will use the Begin and End dates.

Go to HR/Payroll - Reports- Payroll – Pay 60 ACA Measurment Period Report

Start Date - Leave blank to default to today’s date

Months – 12 Default

Minumim Hours - 130.00 Default

Click GO

Review Report to verify employees are expected to be on report

Example PAY60 Report: Use this Report to audit Employee ACA Activity. Full-time Employees should receive a 1095-C Form. IRS Considers Full-time 30 hours per week or 130 hours per month.

Look for hours

that may qualify

for employees

without an

assignment

2016 ACA Review Page 12

Employee ACA Reporting

Go to HR/Payroll - Processes - Tax Reporting - Employee ACA

Review Tools in top right corner to view Escape ACA Reporting User Guide

Defining Your Search Criteria

Calendar Year - Enter the calendar year. Defaults to the open ACA Calendar year.

Employee ID – Leave blank for entire list or Enter the employee ID, can choose multiple employees by enter common in between

Reload Now - Set to YES to reload all employees that have been on a pay cycle in the calendar year

based on the pay cycle date. The reload process DOES NOT overwrite any of your overrides. Open reporting months will update based on changes in Org Record, Benefit Providers, Bargaining Unit, Employee Record, finally it loads the addon and assignment hours from open and processed payrolls.

Loads:

Pay Detail

Organization Setup

Bargaining Unit

Benefit Provider

Employee Record

All open months will be reloaded

Closed months will not be reloaded

Overrides from the tabs of Employee ACA record will not be reloaded

Click Go to generate the list of employees to review

Create Search Favorite

for Employee ACA 2016

Quick Start:

ACA or Enter

To get to Employee ACA

2016 ACA Review Page 13

Review list of employees

Use the Pay60 to verify that all Full-time employees are receiving Form 1095-C

Review the Problem column for possible issues Click on the header in the Problem column to sort Yes to the top of list for easier way to work the list Double click to open the employee record to review

Employee Tab - This is Read Only, if you need to make changes to this information, you can go to

Employee Management or you can use the quick link to make the changes, then you will need to reload to review that it updated on the Employee ACA List.

Covered Individuals Tab – For Self-Insured Only. This is Read Only, if you need to make changes to this

information, you can go to Dependents and Benefit Providers in the employee record or you can use the quick link to make the changes, then you will need to reload.

Offer of Coverage Tab – Uses Bargaining Unit – ACA Default Tab Setup. You can override the full-time

flag, the offer of coverage, the employee share, and the safe harbor method.

Example: Error Message “Unable to determine Barganing Unit”. Typically this error can be resolved by

adding the ACA Bargaining unit on the employee record in Employment Management in the Employee

Tab Section 9 – Benefits.

Use the Quick Link to go to Employee

Management to review and make

changes. Return to search to reload to

review changes, this could take a few

minutes to see changes.

Review Problems

Hover over the

message or move

the columns

width to see full

error

Can Export to Excel to

review Month/Hours

Worked columns; if

employee worked 130 in

any months of the

calendar year, then they

should receive a 1095-C

Form. Doesn’t mean

they qualify for coverage

or offered benefits.

2016 ACA Review Page 14

Hours by Months Tab - You can override the monthly hours amount. Any edits made on this tab will not be overwritten by the Reload. You cannot enter negative numbers.

Click on “Preview” Button to review Form 1095-C - Employer-Provided Health Insurance Offer and

Coverage

This form must be provided and filed for any employee of an ALE who is a full-time employee for one or

more months of the calendar. ALE Members must report the information for all twelve months of the

calendar year for each employee.

Form 1094-C - Transmittal Employer-Provided Health Insurance Offer and Coverage for Returns

This form is electronically filed by SCOE IT

Can override Hours if needed

2016 ACA Review Page 15

Final Submission of Employee ACA Reporting

Due February 10, 2017 by 4:30 pm submit to helpdesk@scoe.org

Go to HR/Payroll - Processes - Tax Reporting - Employee ACA

Run final list of Employee ACA

Calendar Year: 2016

Reload Now? : Yes

Click Go to generate list

From the list, double click on the Form column to get all 1095-C to top of list

Click Export to export to Excel

Example: Excel Format

Excel List

Delete rows with NO 1095-C Forms

Add Column A for form count

Save in a file that you will remember

Send FINAL Excel Employee ACA List to helpdesk@scoe.org

By Friday, February 10, 2017 by 4:30 pm

**Use Search**

Favorite you created

for Employee ACA 2016