Wednesday, November 30, 2016

Why the ACA Made Employer Mandates

ACA Made Employer Mandates
It might not be why you think...

We’ve spoken in-depth before about the employer mandates that were put forth by the Affordable Care Act. But just to give you a refresher, these mandates basically say:
  1. 1. That applicable large employers (ALEs) with 50 or more full-time employees must offer those employees health insurance or pay a per-employee fine,
  2. 2. That the health care coverage offered must meet minimum essential coverage (MEC) at a set minimum value
  3. 3. That the coverage must be offered to full-time equivalent employees as well as actual full-time employees, and
  4. 4. That the coverage must cover the employee’s dependent(s) up to age 26, if applicable.

But one of the big things a lot of employers are wondering when it comes to these mandates is: why? Why should employers have to take on new expenses and potentially change their whole benefits plan(s) because the ACA says so?

Well, one “why” is because you’ll have to pay some pretty big fines if you don’t.

Another bigger, main-er reason why is because the whole point of enacting the Affordable Care Act was to ensure all taxpayers in the US have access to affordable health care coverage. Since most employers already provide some health benefits to their employees, making it so that the coverage they offer meets certain requirements seemed like a logical step.

Since the writers of the Affordable Care Act saw where this could be financially hurtful to the employers, they included safe harbor relief options, which make the transition into these new changes easier for employers.

Be sure to stay tuned with ACAwise and our future blog posts to get the most up-to-date ACA information around! And while you’re at it, why not request a free demo from one of our knowledgeable product managers to help get you set up with ACAwise and prepare for the upcoming ACA filing? We’re available by phone (704-954-8420) and live chat Monday through Friday, 9:00 a.m. to 6:00 p.m. EST and by email 24/7 at

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Wednesday, November 23, 2016

What is Minimum Essential Coverage?

Minimum Essential Coverage
It's time to find out!

In our last post, we very briefly went over minimum essential coverage while talking minimum value as it pertains to the health insurance coverage you offer employees or clients. Today, we’re going to go more in-depth with MEC to ensure your questions are answered!

What is Minimum Essential Coverage?
Minimum essential coverage (MEC), sometimes called “qualifying health coverage,” refers to health care coverage that meets all minimum requirements to be considered compliant with the Affordable Care Act. All taxpayers are required to have health insurance that meets MEC, so employers, insurance carriers, and other providers of health care coverage have a serious obligation to offer it.

“Serious obligation” as in, “Provide it, or be prepared to pay a lot of money to the IRS.”

Types of Minimum Essential Coverage
As a general rule of thumb, these types of health insurance meet MEC requirements:
  • Employer-sponsored coverage that includes COBRA and retiree continuation coverage
  • Coverage that comes from the Health Insurance Marketplace/Affordable Insurance Exchange
  • Medicare Part A coverage
  • Most coverage from Medicaid
  • Coverage from the Children’s Health Insurance Program (CHIP)
  • Certain coverage administered by the Veterans Administration
  • TRICARE coverage
  • Coverage provided through the Peace Corps
  • Coverage provided through non-appropriated Fund Health Benefit Program
  • Refugee Medical Assistance supported by the Administration for Children and Families

If this didn’t answer all of your questions, or if you’re ready to report your MEC to the IRS, check out ACAwise! We’re here to help you e-file Forms 1094 and 1095 and do our best to answer any ACA compliance and e-filing questions you may have! We’re available Monday through Friday by phone (704-954-8420) and live chat from 9:00 a.m. to 6:00 p.m. ET. We also provide 24/7 email assistance at

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Monday, November 21, 2016

What is Minimum Value?

What is Minimum Value?
And why does it matter?

If you’re working to determine the type of coverage you should be providing to your employees and recipients under the Affordable Care Act, you've probably come across two very important phrases: minimum essential coverage (MEC) and minimum value.

Minimum essential coverage is pretty straightforward: it’s the minimum amount of coverage your plan must offer to be considered ACA compliant.

The thing is, this minimum essential coverage must also be provided at a minimum value. So hold onto your hats because now we’re going to dive into exactly what that means.

What is Minimum Value?
Minimum value, at its heart, is a standard of minimum coverage that applies to the health plan(s) you offer. A health plan is considered to have met the minimum value requirement if:
  • It pays at least 60% of the total cost of medical services for a standard population and
  • Its benefits include substantial coverage of physician and inpatient hospital services.
If the coverage you offer meets these requirements as well as MEC, you’re considered compliant in the eyes of the Affordable Care Act.

Reporting Minimum Value
The second part of offering coverage that meets MEC and the minimum value is reporting it! And ACAwise can help you do that quickly, easily , and securely!

Just head on over to our site for more info about setting up a free demo (or) creating your account to start e-filing your 1094 and 1095 forms.

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Wednesday, November 16, 2016

ACA Explained: Measurement Periods

ACA Explained: Measurement Periods

When you look at the basics of one of the major parts of the Affordable Care Act, it seems pretty simple: Applicable Large Employers (ALEs) must provide healthcare coverage to their full-time employees and ALEs are employers with fifty or more full-time employees.

That’s not complicated, right? Just round up your employee data, count it up, if you have more than 50, get to work; if you have less than 50, explore your other options.

Except, of course it’s not that easy. While many employees may work the standard 9-5, 30+ hours per week, full-time gig, there are plenty of others who may work less conventional hours but still meet the qualifications for full-time.

Employees like adjunct faculty, those who work layover hours (like airline industry employees), and on-call employees present an entirely separate dilemma for employers trying to stay compliant with the ACA.

While for regular full-time employees you’re able to use a measurement method to determine their full-time status, the IRS gives employers a full year to determine whether or not a variable hour employee averages 30+ hours of work each week. This time is known as the measurement period.

If, during this measurement period, an employee exceeds the 30 hours/week average, you must make an appropriate offer of coverage to that employee. The coverage must go into effect within 90 days of acceptance and be available for a full 12 months, even if the employee’s hours worked drop back below 30 hours/week.

Since your variable hour employees need to qualify for offers of coverage each year, it’s recommended that employers set measurement periods to start about 90 days before the annual renewal date. So if your company’s renewal date is January 1, a measurement period lasting from October 1 to September 30 of the year before would fulfill this recommendation. Setting your measurement period this way will also make it easier when it comes time to hand out offers of coverage since you’ll just have the one open enrollment period.

ACAwise is equipped to help you determine your employees’ statuses and when it’s time to make offers of coverage. It’s an all-in-one compliance tracking and e-filing program designed to keep you compliant throughout the entire year. To learn more, visit our website or request a free, live demo with the ACAwise team!

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Monday, November 14, 2016

The Next ACA Reporting Deadline

The Next ACA Reporting Deadline

For those of you who thought a Trump presidency would get you out of the upcoming Affordable Care Act filing, maybe don’t bank too much on that one.

You see, this past year, we got a bit of a break as far as filing deadlines went. Since the forms were new and everyone (the IRS included) was having to make serious adjustments to be compliant and complete them, the IRS extended each filing deadline by a few months. This year, we won’t be so lucky.

Even if President-Elect Trump makes good on his promise that the first thing he’ll do Inauguration Day (January 20, 2017) is take steps to repeal, it could very well take longer than he (or we) initially thought. Which isn’t good for those of you putting off getting your ACA Forms 1094 and 1095 together.

January 31, 2017, just eleven days after the inauguration, is the first deadline for the 2016 ACA return forms. January 31 is the date by which you’ll need to mail your employee/recipient copies of Form 1095-B or 1095-C. And if you’re an ALE with hundreds of employees or a third party service provider with hundreds of EINs - and therefore thousands of employees/recipients - that’s a lot of forms to get done in such a short amount of time.

And not long after come the next two deadlines: February 28, 2017, the paper filing deadline for Forms 1094 and 1095 with the IRS, and March 31, 2017, the e-filing deadline.

We think you’d probably rather meet these deadlines head-on with preparedness and accuracy than scramble to meet them, fumbling paperwork and incurring fines. We know we would anyway.

That’s why ACAwise is here to help! We use the payroll and benefits data you already have in place to track compliance and e-file your ACA forms each year. With your information, we’re able to automatically generate the ACA codes needed to, in turn, generate your ACA Forms 1094 and 1095. Then all you have to do is review them and send them off securely to the IRS.

We’ll even provide a little extra help for that big first deadline on January 31: select the postal mailing option before you e-file your return, and we’ll print out your recipient copies and mail them out by the next business day from our headquarters here in Rock Hill, South Carolina. How’s that for easy?

To learn more about ACAwise or set up a free demo to help you get started, contact one of our superb account managers by phone (704-954-8420), email (support@ACAwise.come), or live chat!

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Wednesday, November 9, 2016

Stay Compliant: Beware of These ACA Penalties

Stay Compliant: Beware of These ACA Penalties

A big part of staying compliant with the Affordable Care Act is reporting the coverage you offer with the IRS on Forms 1094 and 1095. After all, if you don’t report that you offered coverage that met minimum essential coverage and value to your full-time employees, how will they know you did?

So not only can not reporting get you in hot water for not covering your full-time employees, it can also incur you some penalties of its own. Even if you did offer adequate coverage, if you don’t report it, you could pay up to $260 per each return not filed. Of course, this penalty can’t exceed $3,193,000 per year, but who has that just lying around?

Oh, and the same penalties apply to the employee copies if you don’t send those out either. And if you don’t have $3,193,000 lying around, are you likely to have $6,386,000 ready to send to the IRS? Didn’t think so.

Now, these penalties could be waived, you’d just need to prove the failure to file was due to reasonable cause (think life-or-death situation) rather than willful neglect.

ACAwise is here to help make sure you’re not at risk for any reporting penalties. We automatically generate your ACA codes and everything needed to complete ACA Forms 1094 and 1095 based on the information you provide. So when it comes time to e-file your forms, all you have to do is review and hit send! Then your forms are instantly processed and sent off for filing with the IRS.

We’ll even mail out your recipient copies! Just select the postal mail option before you transmit your forms and we’ll print them out and mail them from our headquarters in South Carolina by the next business day.

And if you have any questions regarding penalties, ACA filing, or getting started with ACAwise, just give us a call! We’d be happy to set up a free demo to help you learn the program before setting you up with your very own account.

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Monday, November 7, 2016

ACA Explained: Waiting Periods

Affordable Care Act - Waiting Periods

When the Affordable Care Act was passed, it stated that full-time employees must be offered health insurance coverage that meets minimum essential coverage and value no later than the ninetieth (90th) calendar day after the employee meets the plan eligibility requirements.

This 90-day period is known by the ACA as a waiting period. And since the ACA falls under the section of the Employee Retirement Income Security Act (ERISA), if your waiting period does not meet ACA requirements, your employee(s) can sue you for being in violation of the statute.

And to keep you from having to hire a lawyer to interpret the jargon in the ACA, here are those waiting period requirements, in layman's terms:
  • - Your plan can state that employees are eligible for coverage only after 1,200 cumulative hours of service, at which point your 90-day waiting period can be applied.
  • - Your plan can also state that your employees must work a minimum number of hours during the 90-day waiting period. You can also limit coverage to specific job classifications or require licensure.
  • - If your plan has an hours-based eligibility requirement, but the plan cannot determine whether an employee meets this hours requirement, that employee can be considered a variable hour employee and you can use specific voluntary safe harbors to determine if they’re eligible for coverage. 
  • - Your plan can apply different rules for different groups of employees, i.e.:
    • - Collectively bargained and non-bargained
    • - Salaried versus hourly
    • - Those employed in different locations/states

Did you know that ACAwise can help you keep track of your employees in waiting periods and alert you when it’s time to make them offers of coverage? Cause it can! That, plus create and e-file your 1094 and 1095 forms that are required to be filed with the IRS in the next few months. Sign up today for a free demo or create an account to get started entering in your employee and health coverage info for 2017!
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Wednesday, November 2, 2016

How ACAwise Helps Third Party Admins Meet ACA Compliance Needs

Third Party Admins Meet ACA Compliance Needs

When we created ACAwise, we wanted to make a program that worked for everyone who needs to handle ACA compliance and reporting. Of course, we had Applicable Large Employers in mind, but we also had in mind the service providers those ALEs would search out.

Since most ALEs already have a system in place that handles their payroll and benefits and since some employers with self-insured plans won’t file their 1095s anyway, we knew there had to be a solution for third party administrators who would be managing and filing ACA compliance for other businesses.

Enter: ACAwise!

When you sign up for ACAwise as a third party administrator, you have access to our White Label Solution at no additional cost. It comes with the features you need, like multi-user access and multi-client capabilities, and has the ability to run various reports so you can confirm each client’s compliance. White Label accounts also come with a customized version of ACAwise built exclusively for you to market to your clients.

ACAwise’s simplified workflow in the multi-dashboard, cloud-based program helps you manage compliance for any number of clients. Real-time reports and alerts let you know if anyone’s at risk for an IRS penalty, and the ACA Forms 1094 and 1095 you need to file for your clients are automatically generated at the end of each year based on the information you’ve already entered.

So, as you can see, ACAwise is firing all cylinders to make sure you’re able to handle your clients’ ACA compliance and reporting with ease. Contact us today for a free demo of the program or to sign on up!

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