WORKLINX 1095-C/1094-C REPORTING - SmartLinx Solutionsqms.smartlinxsolutions.com/qms/training/docs/SLX ACA... · 2017-02-10 · WORKLINX 1095-C/1094-C REPORTING Version 5.13 2/10/2017

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WORKLINX 1095-C/1094-C

REPORTING

Version 5.13

2/10/2017

Reference Guide This document provides answers to frequently asked questions (FAQs)

on the Affordable Care Act (ACA) and how it is managed within the WorkLinx ACA Director module for Reporting Year 2016.


Table of Contents

1.0 – Quick Reference Guide ..................................................................................................... 3

2.0 – What’s New for the 2016 Reporting Year? ........................................................................... 5

3.0 – Introduction ................................................................................................................... 6

4.0 – Reference Documents ...................................................................................................... 6

5.0 – Reporting Deadlines......................................................................................................... 6

6.0 – Form Deconstruction ........................................................................................................ 7

6.1 – Form Deconstruction 1095-C ......................................................................................... 7

6.1.1 – Part I – Employee and Employer Contact info ............................................................. 7

6.1.2 – Part II – Employee Offer and Coverage ..................................................................... 8

6.1.3 – Part III – Covered Individuals .................................................................................. 9

6.2 – Form Deconstruction 1094-C ....................................................................................... 10

6.2.1 – Part I – Applicable Large Employer Member (ALE Member) ........................................ 10

6.2.2 – Part II – ALE Member Information .......................................................................... 10

6.2.3 – Part III – ALE Member Information - Monthly ........................................................... 12

6.2.4 – Part IV – Other ALE Members of Aggregated ALE Group ............................................ 15

7.0 – User Interface ............................................................................................................... 15

7.1 – 1095-C/1094-C Reporting Page .................................................................................... 15

7.2 – Offer of Coverage Grid ................................................................................................ 16

7.3 – What Employees Are Shown on the Screen? .................................................................. 18

7.3.1 – Adding and Removing Employees ........................................................................... 18

7.4 – Navigation ................................................................................................................. 19

7.5 – Editing Suggested Offers of Coverage ........................................................................... 20

7.6 – Confirming Values ...................................................................................................... 23

7.7 – Audit Reports ............................................................................................................. 23

7.8 – Employee Offer History ............................................................................................... 24

8.0 – Generating Forms and Exports ........................................................................................ 24

8.1 – Generate a 1094-C in PDF (.pdf) Format ....................................................................... 27

8.2 – Generate a 1095-C in PDF (.pdf) Format ....................................................................... 27

8.3 – Generate 1095-C/1094-C Data in XML (.xml) Format for Electronic Filing .......................... 27

8.4 – XSD Validation Errors ................................................................................................. 28


9.0 – Filing 1095-C Information Electronically with the IRS ......................................................... 28

9.1 – Registering for a Transmitter Control Code (TCC) ........................................................... 29

9.2 – Required Communication Testing ................................................................................. 29

9.2.1 – How to Create a Communication Test File in ACA Director ......................................... 30

9.2.2 – How to Submit a Communication Test to the AIR Site ............................................... 32

9.3 – How to Confirm the Results of your Communication Test ................................................. 37

9.4 – How to File Electronic 1095-C Information with the IRS .................................................. 41

9.5 – How to Confirm the Results of your Electronic 1095-C Filing ............................................ 46

10.0 – 1095-C/1094-C Corrections .......................................................................................... 50

10.1 – Background ............................................................................................................. 50

10.2 – Before You Begin: ..................................................................................................... 51

10.3 – Corrected 1095-C ..................................................................................................... 51

10.4 – Corrected 1094-C ..................................................................................................... 54

10.5 – Replacement 1094-C/1095-C ..................................................................................... 57

10.6 – Supplemental 1095-C ............................................................................................... 59

11.0 – Configuration .............................................................................................................. 61

12.1 – Prerequisites ............................................................................................................ 61

11.2 – General Setup .......................................................................................................... 61

11.3 – ACA Additional Tab (Personnel Record) ....................................................................... 61

11.4 – ACA Config .............................................................................................................. 62

11.5 – Benefit Qualification .................................................................................................. 63

11.6 – ACA Coverage Level Setup ......................................................................................... 65

11.7 – Company Setup ........................................................................................................ 66

11.7.1 – Manage Companies ............................................................................................. 66

11.7.2 – Manage Organizations ......................................................................................... 67

Appendices ........................................................................................................................... 68

Appendix A - Logic for Determining the Suggested Offers of Coverage ...................................... 68

A.1 – Suggestions for Months Where an employee is Eligible for Coverage .............................. 68

A.2 – Suggestions for Months Where an Employee is not Eligible for Coverage ........................ 70


1.0 – Quick Reference Guide

What is the 1095-C?

The 1095-C is a document that employers must provide to employees and report to the IRS showing offers of health coverage and

enrollment.

What is the 1094-C?

The 1094-C is a summary of 1095-C forms that an employer files with the IRS when submitting 1095-Cs.

Who should receive a 1095-C?

Any full-time employees or employees that meet the ACA requirements for fulltime (average 30 hours/week or 130 hours/month).

And any employees who were offered health coverage or enrolled in health coverage.

When should we report/file?

For the 2016 reporting year the IRS offered extensions to all employers.

The modified due dates are:

3/2/17 - Provide 1095-C to Employees.

2/28/17 - Report 1095-Cs and 1094-Cs to the IRS on Paper.

o Only employers issuing 250 or less forms.

3/31/17 - Report 1095-Cs and 1094-Cs electronically to the IRS.

o Required for employers filing more than 250 forms, optional for all employers.

In future years the following standard deadlines will be used:

January 31st - Provide 1095-C to Employees.

February 28th - Report 1095-Cs and 1094-Cs to the IRS on Paper.

o Only employers issuing 250 or less forms.

March 31st - Report 1095-Cs and 1094-Cs electronically to the IRS.

o Required for employers filing more than 250 forms, optional for all employers.

How do I edit 1095-C records in ACA Director?

1. Select the facility level or below in the org tree.

2. Open the 1095C/1094C reporting screen with the following navigation:

o ACA Director > File > 1095C/1094C Reporting

3. Select the appropriate ‘Year’ and Click ‘Go’.


What do the cells on the 1095C/1094C Reporting screen mean?

Each cell on the 1095C/1094C Reporting screen represent the offer of coverage and enrollment for 1 month for the employee. 3

Lines are displayed in each cell.

Figure 1 - 1095C Cell Breakdown

How Do I Print the 1095-C?

***Note - Use Chrome – at this time there is an issue using IE to generate 1095-C forms.

The 1095-C and 1094-C can only be generated from the master level.

1. Select the Master Level in the org tree.




4. Click on the ‘Generate Forms and XML’ button.

5. Select the appropriate Company.


6. If generating a 1094-C, the user must answer all the prompts on the screen.

o The prompts on the screen will have no impact on generating the 1095-Cs.

7. Click ‘Generate 1095C’ or ‘Generate 1094C’.

8. The file(s) will generate and download to the user’s PC.

When generating 1095-Cs for more than 25 employees, multiple .PDF files will be created, each containing 25 employee records

with 4 pages per employee. The file could take an hour or more to generate. When generating a 1094-C a single file will

download to the user’s PC.

How do I produce a file for electronic filing?

The 1095-C and 1094-C can only be generated from the master level.

1. Select the Master Level in the org tree.




4. Click on the ‘Generate Forms and XML’ button.

5. Select the appropriate Company.

6. The user must answer all the prompts on the screen.

7. Click ‘Generate XML’.

8. The files will generate and download to the user’s PC as a .zip file.

The .zip file will contain 2 .xml files. Both files will be required when filing electronically with the IRS.

For more details on this process see section “How to Create a 1095-C File for Electronic Filing in ACA Director”.

2.0 – What’s New for the 2016 Reporting Year?

Product updates based on IRS requirement changes for 2016 include:

Updated 2016 1095-C Form.

Updated 2016 1094-C Form.

New offer of coverage codes “1J” and “1K” for conditional offers of coverage.

Removal of offer of coverage code “1I” (retired by the IRS).

Removal of safe harbor code “2I” (retired by the IRS).

Updates to the electronic filing format to meet updated IRS requirements for 2016.

New product enhancements include the following:

Updated suggested offer of coverage and safe harbor codes for an employee's first month of employment.

The ability to setup a default safe harbor code for each benefit plan.

A new control to remove employees from the 1095-C Reporting Screen.

Enhanced validation of IRS business logic.


3.0 – Introduction

The Affordable Care Act requires employers with 50 or more Full Time employees or full time equivalents (FTEs) in the previous year,

to report offers of health coverage and enrollment in health coverage for their employees. The IRS refers to this group of employers

as Applicable Large Employers (ALEs).

In addition, self-insured employers are required to use the 1095-C regardless of the number of Full Time employees or FTEs.

This data is reported at an employee level using the 1095-C. The 1095-C must be provided to the employee and reported to the IRS.

The 1094-C is a summary of the 1095-C data and must be reported to the IRS.

The employer must provide a 1095-C to each employee who is either Full Time or meets the ACA definition of full-time based on

their average hours (30/week or 130/month).

Self-Insured employers must also provide a 1095-C to any employees enrolled in coverage regardless of their full-time status.

At a High Level, each company (FEIN) will issue multiple 1095-Cs (one for each employee as required) and one 1094-C summarizing

those documents.

The IRS supports issuing multiple 1094-Cs reflecting batches of 1095-Cs, but our product only supports issuing a single 1094-C as

the authoritative transmission for all 1095-Cs issued for that company.

4.0 – Reference Documents

The best source for information about the 1095-C and 1094-C is the instruction manual published by the IRS. These instructions will

be referenced throughout this document. This document will also refer to Publication 974 – the Premium Tax Credit.

You will see references to these documents throughout this guide. These documents and more are available from the IRS.Gov

publications website.

The 2016 instruction manual for the 1095-C/1094-C is available in this link: https://www.irs.gov/pub/irs-pdf/i109495c.pdf

Publication 974 Premium Tax Credit (PTC) is available in this link: https://www.irs.gov/pub/irs-pdf/p974.pdf

The forms 1095-C and 1094-C are also available on the IRS.Gov publications website

The 2015 1095-C file is available in this link: https://www.irs.gov/pub/irs-pdf/f1095c.pdf

The 2015 1094-C file is available in this link: https://www.irs.gov/pub/irs-pdf/f1094c.pdf

Publication 5165, Guide for Electronically Filing Affordable Care Act (ACA) Information Returns for Software Developers and

Transmitters is available in this link: https://www.irs.gov/pub/irs-pdf/p5165.pdf

5.0 – Reporting Deadlines

The IRS allowed Extensions to the 2016 reporting deadlines. The updated deadlines are as follows:

Provide 1095-C to Employees - 3/2/17

Report 1095-Cs and 1094-Cs to the IRS on Paper – 2/28/17 (only employers issuing 250 or less forms)

Report 1095-Cs and 1094-Cs electronically to the IRS – 3/31/17 (Required for employers filing more than 250 forms,

optional for all employers)

In future years the following standard deadlines will be used:

Provide 1095-C to Employees – January 31st

https://www.irs.gov/pub/irs-pdf/i109495c.pdf

https://www.irs.gov/pub/irs-pdf/p974.pdf

https://www.irs.gov/pub/irs-pdf/f1095c.pdf

https://www.irs.gov/pub/irs-pdf/f1094c.pdf

https://www.irs.gov/pub/irs-pdf/p5165.pdf


Report 1095-Cs and 1094-Cs to the IRS on Paper – February 28th (only employers issuing 250 or less forms)

Report 1095-Cs and 1094-Cs electronically to the IRS – March 31st (Required for employers filing more than 250 forms,

optional for all employers)

Reference i109495c.pdf pages 2-3

6.0 – Form Deconstruction

6.1 – Form Deconstruction 1095-C

The 1095-C has 3 parts referenced as Part I, Part II and Part III.

All employers must complete Parts I and II.

Self-insured employers must complete Parts I, II and III.

6.1.1 – Part I – Employee and Employer Contact info

Figure 2 - 1095-C Part I

Employee Name, Address and SSN are populated on the form based on the data stored in HRMS

Applicable Large Employer Member (Employer) Name, Address, Contact Info and EIN are populated based on the company

and location data stored in ACA Director/Registry

Company – Contains company contact and EIN information

ACA Director > File > Manage Companies or Directory > File > Manage Companies

Organization – Used to map a facility to a company

ACA Director > File > Manage Organizations or Directory > File > Manage Organizations

(Reference i109495c.pdf page 10)


6.1.2 – Part II – Employee Offer and Coverage

Figure 3 - 1095-C Part II

Part II contains a grid that is intended to reflect the offer of health coverage and enrollment in health coverage for an employee. The

grid contains 13 columns, one for each month and an ‘All 12 months’ column. The grid contains 3 rows referred to as Lines 14, 15,

and 16.

The form allows a user to enter a value in the ‘All 12 Months’ column if the coding is the same for all 12 individual months. Use of

this column is optional. Alternately, the same values can be entered into each of the monthly columns. The WorkLinx ACA Director

product does not support the use of the ‘All 12 Months’ Box at this time and will repeat the value for all months in this scenario.

This section of the form represents the bulk of data that the user will need to verify/edit when using the 1095C/1094C reporting

feature. The user interface for this section of the form is available in the following location in WorkLinx ACA Director:

ACA Director > File > 1095C/1094C Reporting

14 – Offer of Coverage Code

This is a 2-character code identifying the type of health coverage actually offered to the employee each month. Keep in mind, this is

the coverage offered, not the coverage in which the employee is enrolled. A code must be entered in line 14 for each calendar month

January through December, even if the employee was not a full-time employee for one or more of the calendar months. The codes

used in line 14 all begin with “1”. Available codes for 2016 are 1A, 1B, 1C, 1D, 1E, 1F, 1G, 1H, 1J and 1K. (Reference i109495c.pdf

pages 11 - 12)

15 – Employee Share of Lowest Cost Single Coverage

This column contains the amount of the employee share of the lowest-cost monthly premium for self-only minimum essential

coverage providing minimum value that is offered to the employee for each month.


16 – Applicable Safe Harbor Code (Reference i109495c.pdf pages 12 - 13)

This column contains the Safe Harbor Code selected for each month of the year. Only one code can be used for any month. The

codes used in line 16 all begin with “2”. Available codes for 2016 are: 2A, 2B, 2C, 2D, 2E, 2F, 2G, and 2H. The values selected by

the user for this row will depend on the employees’ specific circumstances and the employers ACA compliance strategy. The system

will make a limited number of suggestions for this row. In most cases this file will be populated by user entry.


6.1.3 – Part III – Covered Individuals

Figure 4 - 1095-C Part III

Part III is required for self-insured employers only.

This will include 1 line for the employee and additional lines for each dependent or spouse enrolled in health coverage.

This section includes a column for each month of the year. Months should be checked to indicate that the covered individual was

enrolled in health coverage for any day in the month. **Note: In the current state, the employee will be listed even if they are not

offered coverage. In this scenario, all 12 months will be not checked. We are evaluating a change to not list the employee if they are

not enrolled.

The information in Part III of the 1095-C is populated based on Benefit enrollment data and Dependent enrollment data in HRMS.

Employee Enrollments: HRMS > Employees > Benefits

Dependent Enrollments: HRMS > Employees > Dependents

***Note: Dependent enrollment is determined based on the ‘Coverage Start Date’ and ‘Coverage End Date’ fields. If the data in

these fields are blank, the system will default to the ‘Benefit Start Date’ and ‘Benefit End Date’ fields when determining dependent

coverage.


6.2 – Form Deconstruction 1094-C

6.2.1 – Part I – Applicable Large Employer Member (ALE Member)

Figure 5 - 1094-C Part I

Fields 1 – 8 are populated based on the company data stored in ACA Director/Registry.


Fields 9 – 16 are not currently supported by WorkLinx ACA Director. These fields are specific to government agencies.

Field 18 will be populated by the system based on the number of 1095-Cs produced for the company.

Field 19 will be checked in all cases. This is tied to the assumption that the product will support only producing one 1094-C for each

company at this time.

(Reference i109495c.pdf pages 5-6)

6.2.2 – Part II – ALE Member Information

Figure 6 - 1094-C Part II


Field 20 will be populated by the system based on the number of 1095-Cs produced for the company. This count will match field 18

in Part I.

Field 21 will be populated based on the company setup in ACA Director and Directory.

If more than 1 company is setup with the Same ‘ALE Group’ code as the selected company, this field will be checked.

Company – Contains company contact and EIN information


Field 22 will be populated by the user’s entries on the ‘Generate Forms and XML’ page in ACA Director.

(From the master Level) ACA Director > File > 1095C/1094C Reporting > Generate Forms and XML

***Note “B. Qualifying Offer Transition Relief” was removed for reporting year 2016


Figure 7 - Line 22 (Options)

Figure 8 - Line 22 (Form)


6.2.3 – Part III – ALE Member Information - Monthly

Figure 9 - 1094-C Part III

Part III is populated by a combination of user input on the ‘Generate Forms and XML’ input page and calculations within the system.

Part III Contains a grid with columns labeled a – e and rows for each month and an ‘All 12 Months’ row.


Column (a) Minimum Essential Coverage Offer Indicator

Indicates the months where the employer offered minimum essential coverage to at least 95% of its full-time employees and their

dependents. If the same answer applies to all 12 months in the year, use the ‘All 12 Months’ box.

This section is populated by user input on the ‘Generate Forms and XML’ input page in the section below:


Figure 10 – 1094-C Part III, Column (a)

(Reference i109495c.pdf page 8-9)

Column (b) Full-Time Employee Count for ALE Member

This section is populated based on the systems calculated count of full-time employees per month.

In this case, full-time is someone who is either coded as full-time or meets the ACA definition of full-time based on average hours

(30 hours/week or 130 hours/month).

Column (c) Total Employee Count for ALE Member

This section is populated based on the systems calculated count of total employees per month.

Column (d) Aggregated Group Indicator



Figure 11 – 1094-C Part III, Column (d)


Column (e) Section 4980H Transition Relief Indicator


Figure 12 - 1094-C Part III, Column (e)

(Reference i109495c.pdf pages 9)


6.2.4 – Part IV – Other ALE Members of Aggregated ALE Group

Figure 13 - 1094-C Part IV

This section of the 1094-C is populated based on the configuration entered in the ‘Manage Companies’ page in WorkLinx. Any

company assigned to the same ‘ALE Group’ as the selected company will be listed here. The Name and EIN for each company will be

listed based on the setup in the ‘Manage Companies’ page.


(Reference i109495c.pdf page 9-10)

7.0 – User Interface

7.1 – 1095-C/1094-C Reporting Page

The ‘1095C/1094C Reporting’ Page can be displayed from the File Menu of ACA Director.

ACA Director > File > 1095C/1094C Reporting

The screen will be prepopulated with information depending on the options that you have previously setup in the system. This

includes many of the configuration steps above, such as: ACA Additional Tab entries, ACA Config, ACA Coverage Level Setup,

Manage Companies, and Manage Organizations. Failure to complete all areas of configuration will degrade the quality of

information that the system suggests for reporting.


Figure 14 - ACA 1095C/1094C Reporting Screen

7.2 – Offer of Coverage Grid

The grid at the bottom of the screen allows you to view and edit system recommendations for form population. All suggested codes

(1A, 2C, etc.) are outlined in the official Instructions for Forms 1094-C and 1095-C, provided by the IRS. The most up-to-date

instructions can be found at http://www.irs.gov.

Each cell represents the employee’s data for a single month. The grid is displayed in a familiar calendar-type layout

Each cell contains 3 lines intended to assist the user in viewing and editing an employee’s offer of coverage information.

http://www.irs.gov/


Figure 15 - 1095C Cell Breakdown

Legend

The Legend provides visual cues that are helpful when reviewing employee data in the grid.

Employee Status Cues

Cells highlighted in gray represent months prior to an employee’s hire date.

Cells highlighted in green represent months where the employee was enrolled in benefits for every day in the

month.

Cells highlighted on light orange represent months where an employee was active but not enrolled in

benefits or was enrolled, but not for every day in the month.

Cells highlighted in blue represent months where the employee was no longer actively employed.

Suggestion Status Cues

[Blank Cells] – Blank Cells are shown when the system cannot determine an appropriate suggestion for the employee and month.

[Regular Text] – Regular text indicates that the values in the cell are suggestions and require a confirmation to be included in the

1095-C or 1094-C output.

[Italic Text] – Italic text indicates that the cell value was edited by a user. Hover over the cell to see the value that was originally

suggested by the system.

[Bold Text] – Bold Text indicates that a user has confirmed the entry and it is ready to be included in the 1095-C and 1094-C

output.


7.3 – What Employees Are Shown on the Screen?

By default, the ‘1095C/1094C Reporting’ screen will display any employee who is coded as Full Time (FT), qualifies as ACA FT within

ACA Director, or coded as having received benefits at some point during the year. The user can add or remove employees from the

screen by using the features described below.

7.3.1 – Adding and Removing Employees

Use the ‘Add Employee’ button to add employees to the screen

Figure 16 - Add Employee to ACA 1095 Window

After clicking the ‘Add Employee’ button the ‘Add Employee’ screen will open. Select one or more employees to add to the ‘1095-

C/1094-C Reporting’ screen by clicking the checkbox to the left of the employee record and then click ‘Add’.

Use the ‘Remove Employee’ button to remove an employee from the ‘1095-C/1094-C Reporting’ screen.

1095-C forms will not be generated for any employees removed from the ‘1095-C/1094-C Reporting’ screen.


Figure 17 - Remove Employee from ACA 1095 Window

After clicking the ‘Remove Employee’ button the ‘Remove Employee’ window will open. Select one or more employees to remove

from the ‘1095-C/1094-C Reporting’ screen by clicking the checkbox to the left of the employee record and then click ‘Remove’.

7.4 – Navigation

Year Selector

The Year selector allows you to choose a year to be reflected on the ‘1095-C/1094-C Reporting Page’. After selecting a year, click

the ‘Go’ button to refresh the display on the page.

Tab Control

The tab control at the top of the grid allow you to filter down the employees by their employee type, enrollment status, and

confirmation status.


Page Controls

Records/Page - allows the user to select the number of records that appear on each page.

Page# Dropdown – Allows a user to quickly navigate to a specific page in the results.

Employee Search

Use the magnifying glass icon to search for a single employee record across all pages on the 1095-C/1094-C Reporting

Page. After clicking the magnifying glass icon, a search box will appear in the top left portion of the page. Begin typing an

employee’s name into the search box and the system will filter the results to display employees the matching names.

7.5 – Editing Suggested Offers of Coverage

To edit values within the ‘Offer of Coverage Grid’, you must be at the Facility or Department level of the Organization Tree. Begin by

selecting the cells to edit.

Month Selector – Clicking this check box will select a single month’s entry for all employees on the active page.

Individual Cell Selector – Clicking this check box will select a single month’s entry for a single employee.

All 12 Months Selector – Clicking this check box will select all entries in the selected year for a single employee.

These 3 selectors can be used individually or in combination to select the appropriate employee records for editing.

After selecting the records to be edited click the ‘Multi-Edit Selected’ button.


The ‘Multi-Edit Selected’ screen will allow you to edit the values for the selected cells, and overwrite the system generated

suggestions.

There are 2 options for using the ‘Multi-Edit Selected’ screen:

‘Standard Edit’ mode allows the user to edit cells by answering a few simple questions about the offer of coverage.

‘Advanced Edit’ mode allows the user to enter the Line 14, 15, and 16 values directly.

The screen will open in ‘Standard Edit’ mode by default.

Figure 18 - Multi-Edit 1095 Records Window (Benefits Offered)

1. First indicate if benefits were offered to the employee.

2. If benefits were offered to the employee answer the following questions:

a. What Tier was offered to the employee?

i. If multiple benefits/tiers were offered to an employee choose the most compliant option.

b. What coverage level was offered to the employee?

i. If multiple coverage levels were offered to an employee choose the highest level of coverage.

ii. Employee + Family is the highest Level, Employee Only is the lowest

c. Was the employee enrolled in coverage?

d. Would you like to select an optional safe harbor code?


Figure 19 - Multi-Edit 1095 Records Window (Benefits Not Offered)

1) If benefits were not offered to the employee answer the following questions:

a. What was the reason benefits were not offered?

b. Would you like to select an optional safe harbor code?

The system will use these answers to derive the line 14, 15, and 16 values to use for the 1095-C.

Click on the ‘Advanced Edit’ Button to switch to ‘Advanced Edit’ Mode.

Figure 20 - Advanced Multi-Edit 1095 Records Window

This screen allows you to manually assign values to Boxes 14, 15, and 16 on the 1095-C for those boxes selected. Advanced editing

should only be used by those who are intimately familiar with the Instructions for Forms 1094-C and 1095-C or have been advised

exactly how to do so by legal counsel.

All edited records will be displayed in an italicized typeface and hovering over the cell will display the originally suggested values.


7.6 – Confirming Values

Once you have verified or corrected the values you wish to report on the 1095-C, you will need to confirm them as accurate within

the system. This is completed similarly to multi-editing, and best practices suggest it is completed on a monthly basis to limit the

amount of data manipulation required during year end reporting.

The 1095-C and 1094-C output will only reflect employees with all 12 months’ values confirmed on the ‘1095C/1094C Reporting’

Page.

First, select the employees and months you wish to confirm. Cells can be selected using any combination of the Month selector,

Individual Cell selector, and/or All 12 Months selector.

Click the ‘Submit as Confirmed’ button to confirm the selection.

A confirmation window will appear as shown:

Figure 21 - Confirmation Window

Click the ‘Yes’ button to proceed.

Confirmed selections will now show with a bolded typeface to easily identify which employees/months have been verified and

confirmed.

7.7 – Audit Reports

Clicking on the button will display the 1095-C/1094-C Audit Report screen.

Figure 22 - 1095-C/1094-C Audit Report Screen (Offer Section)

The top section displays all FT employees who were offered minimum essential coverage by month for the year selected.


Figure 23 - 1095-C/1094-C Audit Report Screen (Status Section)

The bottom section shows the number of employee boxes on the ACA 1095C/1094C Reporting screen by department, as well as how

many of them have been confirmed. Comparing the 1095C Employees values versus the 1095C Confirmed values allows you to see

how far you have come in the confirmation process.

7.8 – Employee Offer History

Click the button to display the history of system suggested values and user edits.

Figure 24 - Employee Offer History Screen

Click the button to return to the ‘1095C/1094C Reporting’ Page

8.0 – Generating Forms and Exports

Once all employee records have been confirmed and are ready to be turned into forms, click on the

button from the Corporate level of the Organization Pane.


Figure 25 - Generate Forms and XML Window

Select the company from the ‘Company’ dropdown at the top of the page.

Answer the 4 questions on the screen as appropriate for the company selected:

Figure 26 - Certification of Eligibility Section

Figure 27 - Coverage Section


***Note: Only complete this section if the selected company is a member of an ALE Aggregated Group

Figure 28 - Aggregated ALE Section

Figure 29 - 4980H Transition Relief Section

Red text will appear on the screen to indicate which sections are required based on the company configuration and answers to each

section. These onscreen tips may change based on the answers provided. These onscreen tips will help avoid conflicts when

reporting 1095-C information to the IRS.

Figure 30 - Generate Forms and XML Window (Populated)


8.1 – Generate a 1094-C in PDF (.pdf) Format

Before you begin:

Only confirmed 1095-C entries will be reflected on the 1094-C PDF file. Please ensure that any employee records to be reported are

marked ‘Confirmed’ for all months in the reporting year. Confirmed entries will appear in bold on the ‘1095C/1094C Reporting’ page

in ACA Director.

Click on the button to generate the 1094-C form in PDF format.

Depending on the settings on your PC the PDF will either open in a new browser window or download to your PC.

Downloaded files will appear as an icon on the bottom left corner of the screen.

***Note: For best results make sure to open WorkLinx in Chrome when generating a 1094-C PDF file.

8.2 – Generate a 1095-C in PDF (.pdf) Format

Before you begin:

Only confirmed 1095-C entries will be reflected on the 1095-C PDF file. Please ensure that any employee records to be reported are

marked ‘Confirmed’ for all months in the reporting year. Confirmed entries will appear in bold on the ‘1095C/1094C Reporting’ page

in ACA Director.

Click on the button to generate the 1095-C form in PDF format.

The 1095-C form PDF file will download to your PC.

Downloaded files will appear as an icon on the bottom left corner of the screen.

If the selected company contains more than 25 employee records selected to receive 1095-C forms, a ZIP (.zip) file will be

downloaded. The ZIP file will contain multiple 1095-C.pdf files, each containing 25 employee records.

The employee records will be sorted in Alphabetical order by name within the PDF files.

***Note: For best results make sure to open WorkLinx in Chrome when generating 1095-C PDF files.

8.3 – Generate 1095-C/1094-C Data in XML (.xml) Format for Electronic Filing

Before you begin:

A successful communication test must be completed before filing electronic 1095-C information with the IRS.

If you have not completed a communication test, please refer to the sections below – “How to Create a Communication Test File in

ACA Director” and “How to Submit a Communication Test to the AIR Site”.

If you have completed a successful communication test in a previous year, the communication test is not required for the current

reporting year.

Only confirmed 1095-C entries will be reflected on the 1095-C file. Please ensure that any employee records to be reported are

marked ‘Confirmed’ for all months in the reporting year. Confirmed entries will appear in bold on the 1095C/1094C reporting page in

ACA Director.

1. Click on the button to generate the 1095-C/1094-C data in XML format.


2. A ZIP file will download to your PC.

3. An icon will appear at the bottom left corner of the screen indicating that the file was downloaded.

Figure 31 - Downloaded Zip File Example in Chrome

4. Click the down arrow next to the icon and click ‘Show in folder’ to open your ‘downloads’ folder.

5. Save a copy of the file to your PC.

a. The ZIP file will contain 2 files: a manifest file and a forms file.

6. Open the folder that contains the zip file.

7. Right-click on the filename and choose ‘Extract All’.

This will decompress the contents of the .zip file, and save the manifest and forms files in a format that can be uploaded to the AIR

site.

Do not rename, edit or modify the files created in any way. Modifying these files will result in a failed submission.

***Important Note***

Make sure to save a copy of these files for future reference. These files must be retained as your record of the 1095-C filing

submitted to the IRS.

If any corrections are required at a later date to your submission, these files and the ‘Receipt ID’ discussed later in these instructions

must be submitted with your corrections.

8.4 – XSD Validation Errors

Prior to generating a 1095-C/1094-C XML file, the system will review the employee data for the selected company and determine if

conditions exist that would result in a rejected file based on the IRS XML Schema (XSD).

If conditions exist that would result in a rejected file based on missing employee data, the system will generate an XSD Validation

Error Report.

The report will list the selected company and the affected employee(s).

The report will also list the field(s) that appear to violate the IRS XML Schema.

If an XSD Validation Error Report is generated, correct the missing or invalid information in WorkLinx and repeat the steps above to

generate a 1095-C/1094-C XML file.

9.0 – Filing 1095-C Information Electronically with the IRS

Who must File Electronically?

Any employer issuing 250 or more 1095-C forms in the reporting year must report electronically to the IRS.

In addition, filing 1095-C information electronically is optional for employers issuing less than 250 forms.


What is required for an employer to file 1095-C information electronically?

Employers who wish to file electronically must satisfy 2 requirements prior to filing:

Register for a Transmitter Control Code (TCC).

Complete and pass a required communication test.

What files must be submitted to file 1095-C information electronically?

To file 1095-C information electronically a user must submit 2 files:

1. Manifest File:

a. The manifest file contains information about the company submitting the 1095-C filing and information about the

forms file contained in the submission. This will allow the AIR site to identify the company submitting the

information and help ensure that the form data received is complete and accurate.

b. The file will be named as follows:

i. Manifest1094C_Request_<TCC>_<Date>T<TimeStamp>Z.xml

c. Example:

i. Manifest1094C_Request_BB67Z_20160603T183352000Z.xml

2. Forms File:

a. The forms file contains all 1094-C and 1095-C data for the submission. The forms file will contain information from

a single 1094-C form and one or more 1095-C forms.

b. The file will be named as follows:

i. 1094C_Request_<TCC>_<Date>T<TimeStamp>Z.xml

c. Example:

i. 1094C_Request_BB67Z_20160531T222316000Z.xml

9.1 – Registering for a Transmitter Control Code (TCC)

To submit 1095-C information electronically to the IRS, employers must first register for a Transmitter Control Code (TCC).

This is a 3 step process:

1. Identify the roles within the company who must participate in the application for TCC.

a. This includes 2 responsible officials and 2 contacts.

2. Each individual playing a role in the application must first register for a user on the IRS e-services site.

a. This link contains detailed information about registering with e-services.

3. Complete and submit the application for a TCC.

a. This link contains detailed information about completing the application for a TCC.

9.2 – Required Communication Testing

Each employer filing 1095-C information electronically must first pass a required communication test with the IRS. This test will

ensure the employer can successfully submit files to the Affordable Care Act Information Returns website (AIR).

https://la1.www4.irs.gov/e-services/Registration/index.htm

https://www.irs.gov/PUP/for_taxpros/software_developers/information_returns/aca_app_tutorial_online.pdf


To complete this test, employers must use test files created by their software provider that reflect the TCC code(s) they will use to

report 1095-C information in production. ACA Director Users will create communication test files using the ‘Generate Forms and XML’

page in the ACA Director product. After successful completion of the communications test the employers TCC will be set to

“production” status, enabling submissions using the production AIR website. The communication test is only required for employers

in the first year where they will submit returns.

9.2.1 – How to Create a Communication Test File in ACA Director

1. Open ACA Director.

2. Select the top organization level from the Org Tree.

3. In ACA Director select File > 1095C/1094C Reporting.

4. Select “2015” from the Year drop down.

5. Click ‘Go’.

6. Once the page refreshes click ‘Generate Forms and XML’.

Figure 32 - Generate Forms and XML Window


7. Select the company that is setup with the TCC code to be tested.

8. Click ‘Create Communication Test File’.

***Note – No responses are required for the remaining questions on the page when creating communication test file.

a. A ZIP file will download to your PC.

b. An icon will appear at the bottom left corner of the screen indicating that the file was downloaded.

Figure 33 - Downloaded ZIP File in Chrome Example



11. The ZIP file will contain 2 files: a manifest file and a forms file.

12. The files are specifically designed for use in the communication test only and should only be submitted to the AIR test site.

The files do not contain production 1095-C data.

13. Open the folder that contains the ZIP file.


This will decompress the contents of the ZIP file, and save the manifest and forms files in a format that can be uploaded to the AIR

site.

***NOTE: Do not rename, edit or modify the files created in any way. Modifying these files will result in a failed communication test.


9.2.2 – How to Submit a Communication Test to the AIR Site

This process will be very similar to the one used for submitting production 1095-C data to the AIR site and will help a user familiarize

themselves with the overall process.

1. Navigate to the IRS AIR website.

2. From the ‘UI Channel Link’ menu on the right side of the page click on the link labeled ‘AIR UI Channel Login - AATS

(Testing)’.

Figure 34 - IRS AIR Website (Login Link)

You will be informed that you are leaving the IRS site.

3. Click ‘Leave IRS Site’

4. Enter your username and password for the AIR site.

5. Click ‘Login’

https://www.irs.gov/for-tax-pros/software-developers/information-returns/affordable-care-act-information-return-air-program


Figure 35 - IRS AIR Website (Login Screen)

You will be prompted to select the organization that you will represent in this AIR session.

6. Select your organization (do not select Individual).

7. Click ‘Submit Selected Organization’.

Figure 36 - IRS AIR Website (Organization Selection)

8. You will be prompted to select an AATS version, select ‘AATS 2016’.

9. Click ‘Submit Selected Version’.


Figure 37 - IRS AIR Website (AATS)

You will be prompted to either Upload ACA Forms or Check Transmission Status.

10. In the box labeled “A” click ‘Upload ACA Forms’.

Figure 38 - IRS AIR Website (Upload Forms)

The next screen will allow you to upload the manifest and forms files created above and submit them for processing.

11. Click the ‘Browse’ button in the Upload Manifest section.

12. Navigate to the folder where the communication test files are saved.

13. Select the manifest file.


a. The file will be named as follows:

i. Manifest1094C_CommTest_<TCC>_<Date>T<TimeStamp>Z.xml

b. Example:

i. Manifest1094C_CommTest_BB67Z_20160603T183352000Z.xml

14. Click the ‘Browse’ button in the Upload Form section.


16. Select the forms file.



b. Example:


17. Click ‘Transmit’

Figure 39 - IRS AIR Website (Transmission File Upload)


A page will open confirming your transmission

18. Make note of the ‘Receipt ID’ listed on the page. You will need this information to verify the results of the file upload.

19. Click ‘Print’ to print a copy of this page.

Figure 40 - IRS AIR Website (Transmission Confirmation)

***Helpful Tip***

1. Create a word document in the folder where the communication test files are saved.

2. In the word document save the following information:

a. Paste the address for the AIR site.

b. https://www.irs.gov/for-tax-pros/software-developers/information-returns/affordable-care-act-information-return-

air-program

c. Enter your TCC.

d. Copy and paste the ‘Receipt ID’ and submission date and time from the AIR Transmission Confirmation page.

3. After confirming the result of your submission in the steps below a print screen of that confirmation can be pasted into the

word document as well.




9.3 – How to Confirm the Results of your Communication Test

After submitting a file to the AIR site you must return to the site to confirm the results of your transmission. Processing time may

vary based on the size of your file and traffic on the AIR site. Expect at least 1 hour for your communications test file to process

before it is complete.


2. From the ‘UI Channel Link’ menu on the right side of the page, click on the link labeled ‘AIR UI Channel Login - AATS

(Testing)’.









You will be prompted to select the organization that you will represent in this AIR session









10. In the box labeled “B” click ‘Check Transmission Status’.

Figure 45 - IRS AIR Website (Transmission Status)

11. Enter your ‘TCC’ and the ‘Receipt ID’ received after submitting the communication test file.

12. Click ‘Find’.



A page will open listing the transmission status details.

If the status is listed as “Processing”, then the file is still processing and you will need to return to this page later to verify the

results. Follow the steps above to navigate back to this page.

If the status is listed as “Accepted”, then print or save a screenshot of this page for reference.

Figure 47 - IRS AIR Website (Transmission Status Details)

13. After receiving a status of “Accepted” call the IRS help desk at (866) 937-4130. Make sure to have your TCC code and the

Receipt ID of the accepted communication file available.

14. Inform the IRS representative that you successfully completed your communications test and provide your name, TCC and

the Receipt ID of the accepted communication file.

After verifying the successful completion of the communication test the IRS will move your TCC status from testing to production.

A period of 48 hours will be required to update your TCC status in the IRS system. After this 48-hour period your TCC can be used to

submit 1095-C data in the AIR production system.

***Helpful Tip***

Due to high call volume you may experience a long wait time when calling the IRS help line. Typically, wait times are shorter when

calling at the start of the business day.


9.4 – How to File Electronic 1095-C Information with the IRS

This process will be very similar to the one used for submitting a communication test to the AIR site.


2. From the ‘UI Channel Link’ menu on the right side of the page click on the link labeled ‘AIR UI Channel Login - Production’.


















10. In the box labeled “A” click ‘Upload ACA Forms’.

Figure 52 - IRS AIR Website (Upload Forms)


The next screen will allow you to upload the manifest and forms files created above and submit them for processing.

11. Click the ‘Browse’ button in the Upload Manifest section.


13. Select the manifest file.


i. Manifest1094C_Request_<TCC>_<Date>T<TimeStamp>Z.xml

b. Example:

i. Manifest1094C_Request_BB67Z_20160603T18.3352000Z.xml

14. Click the ‘Browse’ button in the Upload Form section.


16. Select the forms file.



b. Example:


17. Click ‘Transmit’.

Figure 53 - IRS AIR Website (Transmission Upload)


A page will open confirming your transmission

18. Make note of the ‘Receipt ID’ listed on the page. You will need this information to verify the results of the file upload.

a. The ‘Receipt ID’ will also be required if any corrections are required to your filing at a future date.

19. Click ‘Print’ to print a copy of this page.

Figure 54 - IRS AIR Website (Transmission Confirmation)

***Helpful Tip***

1. Create a word document in the folder where the manifest and forms files are saved.

2. In the word document save the following information:

a. Paste the address for the AIR site.

b. https://www.irs.gov/for-tax-pros/software-developers/information-returns/affordable-care-act-information-return-

air-program

c. Enter your TCC.

d. Copy and paste the ‘Receipt ID’ and submission date and time from the AIR Transmission Confirmation page.

3. After confirming the result of your submission in the steps below. A print screen of that confirmation can be pasted into the

word document as well.




9.5 – How to Confirm the Results of your Electronic 1095-C Filing

After submitting a file to the AIR site you must return to the site to confirm the results of your transmission. Processing time may

vary based on the size of your file and traffic on the AIR site. Expect at least 1 hour for your electronic 1095-C submission to process

before it is complete. Based on the IRS documentation, Response time for providing acknowledgement and error data file may take

up to seven (7) days (See Publication 5165).


2. From the ‘UI Channel Link’ menu on the right side of the page click on the link labeled ‘AIR UI Channel Login - Production’.



1. Click ‘Leave IRS Site’.


3. Click ‘Login’.













8. In the box labeled “B” click ‘Check Transmission Status’.


9. Enter your ‘TCC’ and the ‘Receipt ID’ received after submitting the electronic 1095-C filing.

10. Click ‘Find’.


Figure 60 - IRS AIR Website (Transmission Status Search)

A page will open listing the transmission status details.

If the status is listed as “Processing”, the file is still processing and you will need to return this this page later to verify the results.

Follow the steps above to navigate back to this page.

If the status is listed as anything other than “Processing”, print or save a screenshot of this page for reference.

If the status is listed as “Accepted”, then the process is complete.

Figure 61 - IRS AIR Website (Transmission Status Details)

If the Status is listed as “Rejected” or “Accepted with Errors” a list of error conditions will be displayed on the page and a button

labeled “Download” will appear on the page.

11. Make note of the error conditions listed.

12. Click the ‘Download’ button to download an acknowledgement file containing the specific errors encountered.

13. Save the acknowledgement file in the folder created above containing your manifest and forms files.

14. Call SmartLinx Support for assistance.


Figure 62 - IRS AIR Website (Errors)

10.0 – 1095-C/1094-C Corrections

ACA Director > File > 1095C/1094C Corrections

10.1 – Background

After submitting 1095-C files to the IRS AIR website, the site will return 1 of 4 statuses to the user:

Accepted

Accepted with Errors

Partially Accepted

Rejected

Files that receive a status of 'Accepted with Errors' will require the user to submit a corrected file to resolve any errors. These issues

may require corrections to either the 1094-C section, 1095-C section or both sections of the 1095-C forms file.

In some cases, files that receive a status of 'Rejected' will require that a replacement file is created and submitted.

In some cases, you may submit a file that receive a status of 'Accepted' but later realize that one or more employee records were

not included in the file. In this case you will need to submit a supplemental 1095-C file to add the missing records. You may also

need to submit a corrected 1094-C to correct summary data.

In other cases, you may identify issues with records in a file that received a status of 'Accepted' but still reflect incorrect data. In

this case you will need to submit a corrected file.


These scenarios creat the need for 4 different types of correction files:

Corrected 1095-C

Corrected 1094-C

Replacement 1094-C/1095-C

Supplemental 1095-C/1094-C

For additional background and specifics about the 1094-C/1095-C correction scenarios, see Pub 5165 Section 7 (starting on page

42)

www.irs.gov/pub/irs-pdf/p5165.pdf

10.2 – Before You Begin:

Please make sure all the following are True before beginning the 1095-C/1094-C Correction process

You have already submitted a 1095-C/1094-C file to the IRS.

The file was processed by the IRS site and received a status of "Accepted", "Accepted with errors", or “Rejected”.

You have a copy of the 1095-C/1094-C files (manifest and forms files).

You have the Receipt ID received from the IRS when the file was processed.

You have either an acknowledgement file (errors) or a list of employee level records that must be corrected.

You have made any necessary employee level changes in the WorkLinx Application.

o Examples: Name corrections, SSN Corrections, changes to the offer of coverage in the 1095-C/1094-C Reporting

screen, changes to employee benefits enrollments, changes to dependent benefit enrollments.

10.3 – Corrected 1095-C

To create a 1095-C Correction you will need the following:

The 1095-C/1094-C forms file to be corrected

The Receipt ID provided by the IRS for the submitted file

A list of employee level records that must be corrected

Figure 63 - 1095C/1094C Corrections Screen

1. Open the ‘1095C/1094C Corrections’ page.

a. ACA Director > File > 1095C/1094C Corrections

http://www.irs.gov/pub/irs-pdf/p5165.pdf


2. Select the Corporate level of the Organization Pane.

3. Select the ’Year’ to be corrected from the dropdown.

4. Select the ‘Company’ to be corrected from the dropdown.

5. Select “Corrected 1095-C” as the ‘Correction Type’.

6. Enter the ‘Receipt ID’ exactly as it was received from the IRS site.

7. Click the ‘Browse’ button to upload the 1095-C/1094-C forms file to be corrected.

8. The system will validate that the ‘Receipt ID’ matches the expected format.

9. The system will validate that the uploaded file matches the year and company selected.

10. Click ‘OK’. The ‘Select Employees’ page will open.

Figure 64 - Select Employees Screen

11. The ‘Select Employees’ Page will list all of the employee records in the file.

12. The system will attempt to match the records in the files to employee records stored in WorkLinx by SSN.

a. If a match exists, the ‘Name’ listed will match the information currently in WorkLinx and “OK” will be listed in the

‘SSN Match’ column.

b. If a match does not exist, the ‘Name’ will match the employee name in the uploaded file, and “No Match” will

appear in the ‘SSN Match’ column.

13. Resolve any records with “No Match” listed in the ‘SSN Match’ column that require a correction

c. If the employee(s) that require a correction do not show No Match” will appear in the ‘SSN Match’ column skip to

step 19 (below)

d. If an employee listed as “No Match” requires a correction, click the “No Match” link.

i. ***Note – This scenario will occur when correcting an employee’s SSN as part of the 1095-C Correction.

14. The ‘Select Matching Employee’ page will open. This page will list all employees from the selected company.

15. Select the employee.


Figure 65 - Select Matching Employees Screen

16. Select the matching employee record by clicking the checkbox to the left of the employee name.

17. Click ‘Link Records’. You will return to the ‘Select Employees’ Page.

Figure 66 - Select Employees Screen

18. Select the employees to correct by clicking the check box to the left of the employee’s name.

19. Click to generate a 1095-C correction XML file. A ZIP file will download to your PC.






23. The ZIP file will contain 2 files: a manifest file and a forms file.



a. This will decompress the contents of the .zip file, and save the manifest and forms files in a format that can be

uploaded to the AIR site.

b. Do not rename, edit or modify the files created in any way. Modifying these files will result in a failed submission.




If any corrections are required at a later date to your submission, these files and the ‘Receipt ID’ discussed later in these

instructions must be submitted with your corrections.

26. Click to generate a Corrected 1095-C PDF file.


10.4 – Corrected 1094-C

To create a 1094-C Correction you will need the following:

The Receipt ID provided by the IRS for the submitted file



Figure 68 - 1095C/1094C Corrections





5. Select “Corrected 1094-C” as the ‘Correction Type’.


a. The system will validate that the ‘Receipt ID’ matches the expected format.

7. Click ‘OK’.

a. A page will open with questions similar to the ‘Generate Forms and XML’ page.

Figure 69 - Corrected 1094-C Window (1)

8. Answer the 4 questions on the screen as appropriate for the company selected.

9. Click ‘Next’. A Page will open showing the Count of Fulltime Employees and Total Employees by Month and the total count

of 1095-C files submitted for the selected company.


Figure 70 – Corrected 1094-C Window (2)

10. Review and edit the counts if needed

11. Click to generate a 1095-C correction XML file. A ZIP file will download to your PC.









a. This will decompress the contents of the ZIP file, and save the manifest and forms files in a format that can be









10.5 – Replacement 1094-C/1095-C

To create a Replacement 1094-C you will need the following:

The Receipt ID provided by the IRS for the file above







5. Select “Replacement 1095-C” as the ‘Correction Type’.


a. The system will validate that the ‘Receipt ID’ matches the expected format

7. Click ‘OK’. A page will open with questions similar to the ‘Generate Forms and XML’ page.


Figure 73 - Replacement 1095-C Window

8. Answer the 4 questions on the screen as appropriate for the company selected.

9. Click to generate a replacement 1094-c/1095-C XML file. A ZIP file will download to your

PC.

















10.6 – Supplemental 1095-C

To create a Supplemental 1094-C you will need the following:

The 1095-C/1094-C forms file to submitted earlier to the IRS.







5. Select “Supplemental 1095-C” as the ‘Correction Type’.

6. Click ‘Browse’ to upload the 1095-C .xml file submitted earlier. A page will open listing employees in the selected company

that were not included in the file uploaded above


Figure 76 - Supplemental 1095-C Window

7. Select the employees to include in the Supplemental 1095-C file.

8. Click to generate a Supplemental 1095-C XML file. A ZIP file will download to your PC.





a. The .zip file will contain 2 files: a manifest file and a forms file.

12. Open the folder that contains the zip file.

13. Right-click on the filename and choose ‘Extract All’









14. Click to generate a Supplemental 1095-C PDF file.

15. Click to generate a Supplemental 1095-C PDF file.


11.0 – Configuration

12.1 – Prerequisites

1. ACA Director 2. Time and Attendance (for determining ACA FT/PT) 3. HRMS (with Benefits)

11.2 – General Setup

The Following must be completed for this feature to work:

Company Setup

Organization Setup

Benefits Setup

Coverage Level Setup

11.3 – ACA Additional Tab (Personnel Record)

Figure 78 - ACA Additional Tab (Employee Record)

In order for the ACA Director Dashboard to work correctly, prior setup is required for each employee. This can be accomplished from

within the employee’s Personnel Record which is accessed by clicking on the employee’s name in most areas of WorkLinx.

Within the ACA Additional tab there are four items that must be considered for each employee. These are:

Employee is not eligible for Full Time Status under Affordable Care Act – This item should be checked if the employee is of a

temporary status such as agency employees. This will disqualify them from all ACA calculations.


Benefit coverage declined by Employee – This item should be checked if the employee has decided not to use the company

offered benefit plan. Those who choose to find private coverage should have this box checked.

Purchased coverage through Health Insurance Marketplace – If an employee chooses to use a plan offered through the

Health Insurance Marketplace, this item should be checked.

Annual Household Income – This field should be populated by the employee’s annual household income value, if known. If

not known, this field should be manually populated by the employee’s annual salary, as a lesser value will not be valid.

11.4 – ACA Config

The configuration screen for ACA data can be accessed from the View Menu within ACA Director by selecting:

View > Configuration > ACA Config

There are two tabs that you will need to populate to configure your ACA Director: Standard Config and New Hire Config.

Figure 79 - File Menu (ACA Director)

The Standard Config tab allows you to setup the lengths for the Measurement, Administrative and Stabilization periods for all current

employees.

You can also use the First Day of Measurement field to define when the original Measurement Period will begin.

Figure 80 - ACA Config Window (Standard)

The New Hire Config screen is similar to the Standard Config but is only used for newly hired employees within WorkLinx.


The Start of Measurement field allows you to define when the new employee’s Measurement Period will start. If checked, the period

will start on the first of the next month (i.e.: October 1st, November 1st, etc.). If unchecked, the period will start on the employee’s

date of hire.

The various Period fields are identical in nature to the Standard Config and should be setup accordingly.

When both tabs are filled out appropriately, click the ’Save’ button to complete configuration.

Figure 81 - ACA Config Window (New Hire)

***Note: Changing either of these configurations will require communication to SmartLinx Support.

11.5 – Benefit Qualification

The Benefits screen of the HRMS module now allows you to setup each health benefit plan’s definition for ACA Compliance. This will

display on the benefit’s definition.

In order for a health benefit to be considered ACA Qualified, it needs to meet the minimum guidelines for the Affordable Care Act. It

is the client’s responsibility to select if the benefit qualifies for Minimum Elected Coverage (MEC), Minimum Value (MV), and the

Poverty Level Test. The ACA Compliance fields will need to be checked for each qualification.

• MEC – Does this Plan Offer Minimum Essential Coverage as defined by the ACA?

• See page 8 of Pub 974 for a detailed description

• MV – Does this Plan Offer Minimum Value as defined by the ACA?

• See Page 14 of the instructions for the 1095-C/1094-C

• Poverty Level Test – Is the employee contribution for self-only coverage equal to or less than 9.5% of the mainland single

federal poverty line?

In addition, the ACA Director product now supports adding a ‘Default Safe Harbor Code’ for each Medical Benefit/Tier combination.

The default safe harbor will be suggested for employees in months were they were eligible for medical coverage but did not enroll.

Please consult your legal or benefits advisor about your plans to ensure that you correctly populate these fields!


Figure 82 - Benefits Screen (Health)

Figure 83 - ACA Compliance Section (Health Benefits)


11.6 – ACA Coverage Level Setup

The ACA Coverage Level Setup screen is available from the File Menu within the ACA Director module.

ACA Director>File>Coverage Level Setup

Figure 84 - ACA Coverage Level Setup Screen

This screen is setup like a reporting screen, but is actually used to assign ACA Category, Spouse and Dependent(s) to each Benefit

Tier within the system. Once loaded, you can click on the cell for any of these three categories and it turns into a dropdown that

allows you to select the proper coding. This MUST be done in order for the system to offer the appropriate suggestions for

populating the 1095C forms for each employee. Your benefits provider or legal counsel should advise you which options to use when

selecting these fields as the law makes them less self-explanatory than you might think at first glance.

Options available are as follows:

ACA Category

EE Family – Employee and Family coverage

EE Dependents – Employee and dependents only

EE Spouse – Employee and Spouse only

EE Only – Employee only or employee with a limited number of dependents

Spouse

o True – Spouse is included.

o False – Spouse is NOT included.

Dependents – Maximum number of dependents covered. Use 99 for unlimited

Figure 85 - Coverage Setup Dropdowns


11.7 – Company Setup

In order for the 1095-C and 1094-C forms to be properly populated, you will need to enter some additional information about your

company and facilities into the system. This is accomplished from the File menu within ACA Director.

11.7.1 – Manage Companies

ACA Director > File > Manage Companies

The Manage Companies screen allows you to setup your company information that would be used for the ALE (Applicable Large

Employer) fields on the ACA forms. The initial screen gives you a breakdown of all of your companies and their key information. A

company’s information can be edited by clicking on their hyperlinked name.

Figure 86 - File Menu (ACA Director)

By clicking on the ‘Add Company’ button, you can add a new company on the company.

Although only two fields are required, Legal Name and Federal EIN (FEIN), you should fill out as many as possible to ensure the

forms are populated in their entirety.

Most of the fields are self-explanatory when setting up your company. However, ALE Group is a new field that is specific to 1095-C

and 1094-C Reporting.

The ‘ALE Group’ field will allow you to define relationships between companies that make up an Aggregated ALE Group. Any

companies assigned to the same ‘ALE Group’ will be considered an Aggregated ALE Group for 1095-C and 1094-C Reporting.

More information on Aggregated ALE Groups can be found in the instructions for Forms 1094-C and 1095-C, provided by the IRS.

When all possible fields are populated, click the ‘Save’ button to complete the configuration.

Figure 87 - Company Window


11.7.2 – Manage Organizations

ACA Director>File>Manage Organizations

Figure 88 - Manage Organizations Screen

The Manage Organizations screen works similarly to the Manage Companies screen, but lists all facilities within the system. Click on

the hyperlinked name of each facility in order to edit them.

Figure 89 - Organization Window

Within the Organization window that appears, use the ‘Company’ dropdown to select which company the facility belongs to. This will

need to be completed for EVERY facility within the system for the 1095-C and 1094-C reporting data to populated correctly.

The lower left box allows you to enter address information for the facility.

Finally, the CMS PBJ Facility ID should be populated with the applicable code in order to update the PBJ export information that will

be sent to the Center for Medicare and Medicaid Services.


Appendices

Appendix A - Logic for Determining the Suggested Offers of Coverage

Below is a summary of the logic used to determine the suggested offer of coverage on the 1095-C/1094-C Reporting Page.

A.1 – Suggestions for Months Where an employee is Eligible for Coverage

The system will make suggestions of coverage based on the most compliant Medical Benefit/Tier combination that the employee is

eligible to receive. This logic is based on the benefit setup and eligibility rule data entered in WorkLinx.

To explain this logic, we will begin with a simple scenario where an employee is eligible for just a single Medical Benefit/Tier

combination.

The system first looks at the ‘ACA Compliance Indicators’ setup for the Medical Benefit/Tier combination.

Figure 90 - ACA Compliance (Health Benefits)

Next the system will determine the highest level of coverage offered to the employee.

For this logic offers of coverage are ranked with “EE Family” as highest offer and “EE Only” as the lowest offer of coverage. They are

sorted in following order:

EE Family

EE Dependents

EE Spouse

EE Only

This logic is based on the ‘ACA Category’ assigned on the ‘ACA Coverage Level Setup’ screen.

Figure 91 - ACA Coverage Level Setup Screen


The system then uses the ‘ACA Compliance Indicators’ and highest level of coverage (discussed above) to determine the suggested

line 14, 15 and 16 values using the table below.

Table 1 – MEC Scenarios

If the employee is eligible for more than one Medical Benefit/Tier combination, the system uses the following logic to choose the

most compliant Medical Benefit/Tier to use as a basis for the suggestion.

Figure 92 - ACA Compliance (Health Benefits)

Each ‘ACA Compliance’ indicator is assigned 1 point.

Minimum Essential Coverage

Minimum Value

Poverty Level Test

If all 3 indicators are marked ‘True’ – the Medical Benefit/Tier combination receives a score of 3.

If 2 of the indicators are marked ‘True’ – the Medical Benefit/Tier combination receives a score of 2.

If only 1 of the indicators are marked ‘True’ – the Medical Benefit/Tier combination receives a score of 1.

The system will base its suggestions on the Medical Benefit/Tier combination with the highest score.

In the event of a tie, the system will determine if both the Medical Benefit/Tier combinations will result in the same line 14 code.

If so the system will base its suggestions on the first Medical Benefit/Tier combination.

if both the Medical Benefit/Tier combinations do not result in the same line 14 code, the system will prompt the user to select the

Medical Benefit/Tier combination to use as the basis of the suggestion. The system will only prompt the user to resolve a tie 1 time

when the suggestions are first loaded to the screen.


A.2 – Suggestions for Months Where an Employee is not Eligible for Coverage

Suggestions for months where an employee is not eligible for coverage are based on the reason the employee is not eligible.

The table below summarizes the logic used for these suggestions.

Table 2 - Coverage Scenarios