AFFORDABLE CARE ACT (ACA) REPORTING CONSIDERATIONS

Transcription

1 AFFORDABLE CARE ACT (ACA) REPORTING CONSIDERATIONS PRESENTED BY: FELICIA BARNES-HODGE, FISCAL ANALYST ESD 113 My Partner For Learning Solutions

2 ACA - The Goal & Disclaimer The Goal The goal is to provide affordable heath care coverage available to everyone in the United States through an employer, a governmentsponsored agency or a public exchange (Marketplace). Disclaimer We share this information with our clients for general informational purposes only. It does not necessarily address all or your specific issues. It should not be construed as, nor is it intended to provide legal advice. Questions regarding specific issues and applications of these rules to your plans should be addressed by your legal counsel.

3 ACA AN OVERVIEW OF WHY? The IRS is collecting affordable care information from the employee (Individual Mandate), insurance carriers, and the employer (Employer Mandate). Individual Mandate (1095-C) informs the IRS the employee has coverage or pays a fee when taxes are filed Employer Mandate (District) informs the IRS the Offer of Coverage was/was not offered and why or pays a fee when forms 1094-C & 1095-C are transmitted by the District (similar to W2 process)

4 POSSIBLE PENALTIES If employee receives a subsidy from the marketplace: No 1095-c filed by district* $250 per unfiled return Not to exceed $3,000,000 each calendar year Incorrect return filed $250 per unfiled return Not to exceed $3,000,000 each calendar year For 2015, IRS will not impose this penalty when good faith effort is shown to comply with reporting requirements

5 POSSIBLE PENALTIES 70% Rule If no offer of coverage was given to at least 70% of all full-time employees* 1/12 of $2,000 multiplied by the number of full time employees employed for the month minus 80 Minus 30 in 2016 & beyond *For 2016 and beyond, it becomes 95% of full time employees Offer of Coverage is Inadequate (Minimum Value) Offer of Coverage is Unaffordable If employee s share of coverage would cost the employee more than 9.5% of household income Safe Harbors will apply here

6 ACA REQUIREMENTS Review hours monthly Monitor monthly measurement period Determine reportable employees Determine Offer of Coverage Identify Safe Harbors, if needed Provide 1095-C to reportable employees Submit 1094-C and 1095-C to IRS

7 CAPTURING ALL HOURS OF SERVICE Hours of Service Each hour an employee is paid for the performance of duties for a period of time Each hour an employee is entitled to be paid for a period of time during which no duties were performed due to vacation, holiday, illness, incapacity (including disability), layoff, jury duty, military duty or leave of absence (including vacation/sick leave cash outs)

8 CAPTURING ALL HOURS OF SERVICE CONT D Coaching and Stipend contracts are going to need some hours attached to it and must not be less than minimum wage ($9.47) and must be reasonable hours. EXAMPLE: Annie Oakley is a Head basketball coach paid $3,000 for a 3-month contract. If we use a rate of $10/hour it equals out to 300 hours. If we use her contract pay of $35/hour it equals 85.5 hours. Depending on the scope of work performed, both could be considered reasonable hours & above minimum wage. Consider meeting with the Athletic Director or Administrator in charge of Coaches and the same for the person in charge of stipend positions. Hours may trigger change in ACA reporting requirements

9 ESTABLISH A MEASUREMENT PERIOD The Look-Back Method is recommended for school districts however there is a monthly measurement option Measurement should be between 3 12 months Exclude school year breaks and summer break OR credit the employee with average hours during the break Must choose a consistent period for all employees

10 DEFINITIONS FOR ACA DATA COLLECTION Full-Time Employee Employees who work at least 30 hours per week or 130 service hours for more than 120 days per year With respect to any month, hired to work at least 30 hours per week or 130 hours per month (The 130 hours of service standard is equal to 30 hours of service per week times 52 weeks divided by 12 calendar months.) This includes certificated and classified substitutes NOTE: If employer has less than 50 full-time employees (by ACA standards), the district is not obligated to meet this reporting requirement although it is recommended

11 DEFINITIONS FOR ACA DATA COLLECTION CONT D PART-TIME EMPLOYEE Hired to work less than average of 30 hours per week on a consistent basis (no more than 120 hours per month) VARIABLE HOURS OR SEASONAL EMPLOYEE Hired to work a variety of different hours or hours are constantly changing

12 DEFINITIONS FOR ACA DATA COLLECTION CONT D Full-Time Equivalent Employees Hours of service for part-time employees (up to 120 hours) per person per month divided by 120 equals the number of full-time equivalent employees for the month This is needed to help capture the total number of ACA full-time employees that are reported on the 1094-C each month. What is considered a part-time employee by ACA standards? Employees hired to work less than average of 30 hours per week on a consistent basis

13 FT COUNT EXAMPLE Calendar Year 2015 Jan Feb Mar # of Employees per month # of FT Employees 130 hrs/month # of Part Time Employees (less than 30hrs per week) Variable / Seasonal Employees (don't report) Total # of Part-Time Employee Hours per month # of FT Equiv EE 120 hrs/month Total ACA FT & FT Equiv EE % Minimum 98% 96% 98%

14 DEFINITIONS FOR ACA DATA COLLECTION CONT D Offer of Coverage (What coverage was offered or not) Series 1 Codes describe the coverage that is offered to the employee and his or her spouse and dependent(s), if any exist. Safe Harbor (Why coverage was offered or not) Series 2 Codes provide the IRS with information to administer the employer shared responsibility provisions. These codes indicate that under a rule of Safe Harbor, the employer is not subject to an assessable payment under Section 4980H(b) for the month, or that the health coverage offered is treated as affordable for purposes of Section 4980H(b).

15 PROVIDING INDIVIDUAL STATEMENTS Follows the same guidelines as the W-2 process General Rule: Provide 1095-C statement by mail to last known permanent (or temporary) address Electronic statements is an option but there are certain consent requirements (Contact the ISC for assistance)

16 DUE DATES & RECORDKEEPING Furnishing Form 1095-C to Employees January 31 st of each year If this date happens to fall on a weekend/holiday, file by next business day ( For 2015 filing the due date is February 1, 2016). Furnishing 1094-C (Transmittal) and 1095-C (Individual) to IRS February 29, 2016 if filing by paper March 31, 2016 if filing electronically If filing more than 250 returns, filing electronically is required Keep copies or have the ability to reconstruct the forms 3 years from the due date of the forms

17 WHAT DISTRICTS CAN DO NOW Determine if your district is an applicable large employer (ALE) Become familiar with IRS Instructions for 1094-C and 1095-C Become familiar with Series 1 & 2 codes Register for IRS e-services account Request an IRS ACA Transmitter Control Code (TCC) Identify all employees who should receive a 1095-C form Determine if Offer of Coverage was/was not offered and why (Safe Harbor) Consider using a spreadsheet to collect all data needed to import into the system when update is released

18 ACA REPORTING TIMELINE District (Ongoing) Skyward DF Release (November 14, 2015) District (November/December) District (January March) Create ACA Spreadsheet Spreadsheet Maintenance ACA-related fields Import Spreadsheet or Manual Entry Mass Process Reporting C/1095-C ISC Printing Transmit file

19 UPCOMING ACA TRAININGS WEDNESDAY, NOVEMBER 18, 2015 WEDNESDAY, DECEMBER 9, 2015 THE FOLLOWING TRAININGS WILL INCLUDE ACA UPDATES, W2 & 1099 PROCESSING WEDNESDAY, DECEMBER 16, 2015 FRIDAY, JANUARY 8, 2016 MONDAY, JANUARY 11, 2016

20 HELPFUL RESOURCES Internal Revenue Service US Department of Labor WA State Health Care Authority SKYDOCS - WSIPC GUIDE TO AFFORDABLE CARE ACT DATA COLLECTION (UPDATING REGULARLY)

21 QUESTIONS? Contact ISC: Phone: