ACA Compliance/Insurance Eligibility

Several components of the Human Resources Management software work hand in hand to manage insurance eligibility, enrollment and Affordable Care Act compliance/reporting.

At this time the HRM software works in conjunction with the payroll modules of Datatech’s accounting packages.  Hours needed for insurance eligibility are pulled directly from check records. The following are some of the main features of this cutting edge software module from Datatech.

ACA Employee Category

This window defines the structure of insurance eligibility for different classes of workers. For example, you may elect to have a class of workers on a look-back period of 3, 6 or 12 months for determining eligibility, while having field workers on a monthly schedule.

If you’re using a look-back method for determining eligibility, you can define the number of days for your look-back Measurement, Administrative and stability periods. For a Monthly plan, the look-back period will be one month with no administrative or stability periods.

ACA Employee Status
Each employee will have to have an ACA status assigned. This tells the program which category to apply for determining eligibility and sets the measurement dates. For a monthly method, the Measurement Start and End dates will be the prior month. As the Hours/Eligibility Report is generated, the measurement period will automatically be updated.

Medical Plan
You can set up multiple insurance plan details. This will be used to track which plans employees are offered/accepted and for transmitting that information to the plan administrator. A default plan can be assigned for automatically creating benefit records.

Hour/Eligibility Report
The Hour Eligibility Report will calculate the hours worked per month (Monthly method) and determine if the employee is eligible for insurance. It will automatically update the Insurance Benefit record with the default medical plan and eligible date.

The Benefit Eligibility Review window was designed to stream-line the process of entering employee accepted/declined insurance information.

Enter Insurance Coverage
If you open an entry in the Benefit Eligibility Review window you will get an expanded Insurance Coverage window where you can add more information on declined coverage, change the insurance plan and enter deduction information if applicable.

As consecutive months progress with the employee retaining insurance eligibility, the program will automatically update the Ending Date on coverage. This information will be used when reporting on the IRS forms 1094C and 1095C.

1094C/1095C Forms
Datatech’s Human Resources program will store all of the information that is required to be reported on the 1095-C, including both section 6056 (required of all employers) and section 6055. Employers will be required to provide employees this form at the end of the year and the form can be mailed along with their W-2.

Providers of minimum essential coverage, including employers providing coverage under a self-insurance group health plan, are subject to the “Section 6055” reporting requirements. This includes information reporting on who is covered under a particular health insurance policy (e.g. the employee and/or spouse and/or dependents) and what months they were covered.

The first 1095-C forms are being filed this year for the 2015 calendar year.

A transmittal form, the 1094-C, will also be filed with the IRS. Electronic reporting of the information to the IRS will be possible; subject to the same rules as electronic reporting of W-2 information (i.e. electronic reporting is required for 250 employees or more). Files with the 1095-C information will be uploaded to the IRS web site just as you currently upload the W-2 electronic files to the SSA’s web site.