Everything to Get Ready and File for ACA

Last Updated: December 2020

This article will cover everything needed for generating 1094/1095 forms from double-checking required data for an employee, generating your forms, review your forms, and making corrections.

Table of Contents

What is ACA?

ACA – Affordable Care Act (Sometimes referred to as Obamacare) – 3 primary goals:

  • Make affordable health insurance available to more people.
  • Expand the Medicaid program to cover all adults with income below 138% of the federal poverty level. (Not all states have expanded their Medicaid programs.)
  • Support innovative medical care delivery methods designed to lower the costs of health care generally.

Filing Process

Providing Consent to file 1094/1095 Forms with the IRS.

  • Arcoro must receive your consent to file your 1094/1095 data with the IRS prior to transmitting any files.
  • The deadline to provide consent to file must be received by Month Date, Year.
  • Consent to file is required for both original files and any correction files.
  • Your consent to file should be sent to your account manager who will verify ACA filing services in your contact and notify the ACA team.

ACA_Filing_Process_-_00.png

Common IRS Filing Statuses

You can have any of the following statuses when filing with the IRS.

  • Processing
    • Your file has been received is still being processed.
  • Accepted
    • The IRS identified discrepancies between your filing information and the IRS database.
  • Accepted with Errors
    • There was no rejected data, but there were one or more records that presented errors.
  • Rejected
    • There were one or more fatal errors causing the transmission to fail. Note: In this case, all records should be resubmitted, not corrected.

Checklist

To make your ACA filing as smooth as possible, here some things for you to double-check.

Company Name and EINS

Company Name and EIN - Confirm that the Business name(s) and corresponding EIN(s) are configured in InfinityHR and match with the IRS Database entry.

  1. From the menu, expand Setup and go to Setup Properties.

    Company_Names_-_00.png

  2. Hover over the "General" tab and click Employers.

    Company_Names_-_01.png

  3. If the employer already exists, click the company name to view additional information.

    Company_Names_-_02.png

  4. Review the Employer Name and EIN (Federal Tax ID) and confirm that they are correct.

    Company_Names_-_03.png

  5. If the employer has not been entered, use the Actions drop-down menu, and click Add.

    Employer_-_02.png

  6. Enter the appropriate employer information.

    Employer_-_03.png

  • The IRS will only accept transmittals that use the business name and corresponding EIN they have on record.
  • "Doing Business As" (DBA) will be rejected.
  • A minimum of one Employer must be configured on the Employers page.
  • More Employers can be added if multiple legal entities are associated with the organization.

Employee Status History

Employee status history documents status changes specific to an employee over the course of the employee life cycle, including changes to employee status, ACA status, and benefit status. The ACA module refers to the employee status history to generate IRS form 1095-C.

Employee Status History Report

  1. From the menu, expand Reports, expand Employees, and click General.

    Employee_Status_-_00.png

  2. Click the filter icon to include all status changes.

    Filter_Icon.png

  3. Change the start date to 1/1/1900 and the end date to today's date.

    Employee_Status_-_01.png

  4. Click Refresh Results.
  5. Use the report labeled "Employee Status History" by clicking the Excel icon to save an Excel file to your computer.

    Employee_Status_-_02.png

  6. Open the save Excel file.
  7. Click the header for Column B for the employee's full name.

    Employee_Status_-_03.1.png

  8. While viewing the Home tab in Excel, go to Conditional Formatting, go to Highlight Cell Rules, then click Duplicates Values....

    Employee_Status_-_03.2.png

  9. Select the desired option for formatting the duplicate values.

    Employee_Status_-_04.png

  10. Review the highlighted cells and for any of the following on the row:
    1. Employee Status Change (Full-time to Part-time or vice-versa)
    2. Benefit Status Change (Active to Inactive or vice-versa)
    3. ACA Status Change (Full-time to Part-time to Seasonal to Variable)
    Employee_Status_-_06.png
  11. Confirm that each highlighted cell represents a unique status change/date combination. All duplicates will need to be deleted on the employee's ACA profile.
  12. Note total lines of data included in the report.

Employee Quick Excel Report

  1. Expand Data, expand Exports, and click Manage.

    Employee_Quick_Excel_-_00.png

  2. Hover over "Quick Excel Exports" and click Export Employees.

    Employee_Quick_Excel_-_01.png

  3. Count the number of employees in the Excel spreadsheet (Reference Column A: SSN)

    Employee_Quick_Excel_-_02.png

Compare Employee Count

  1. Compare the total number of employees listed in the Employee Status History report with the total number of employees listed in the Employee Quick Excel report.
  2. The Employee Status History report should always have more lines of data than the Employee Quick Excel report (assuming that at least one employee has had a status change).
  3. If not, then refer to the following section, "Enter Missing Data."

Enter Missing Data

Manually Enter Employee Status History Changes

  1. From the menu, expand Employee, expand Benefits, and click ACA Profile.

    Enter_Missing_Data_-_00.png

  2. Click the Employee Status History tab.

    Enter_Missing_Data_-_01.png

  3. Enter the appropriate change dates, employee status, ACA Employee Status, and Benefit Status as of that date.

    Enter_Missing_Data_-_02.png

  4. Click Save.

Import Multiple Status Changes using Employee Status History Import Template

  1. Create an Excel document based on the layout detailed in the following article: Employee Status History.

    Enter_Missing_Data_-_05.png

  2. From the menu, expand Data, expand Imports, and click Standard.

    Enter_Missing_Data_-_03.png

  3. From the "Import Type" drop-down menu, select "Employee Status History."

    Enter_Missing_Data_-_04.png

  4. Click "Browse" to upload the Excel document created from Step 1.
  5. Enter the worksheet name from the Excel document.
  6. Click Import File.

Confirm Data Has Been Successfully Added

Once all the data has been entered/imported, you can use any of the following options below to confirm the data has been successfully added.

Repeat Steps 1-3

  1. Employee Status History Report
  2. Employee Quick Excel Report
  3. Compare Employee Count

Review Employees' ACA Profiles

  1. From the menu, expand Employee, expand Benefits, and click ACA Profile.

    Enter_Missing_Data_-_00.png

  2. Click the Employee Status History tab.

    Enter_Missing_Data_-_01.png

  3. Review information.

    Review_Status_-_00.png

Medical Benefits

Ensure medical plans are configured correctly (premiums, contributions, Minimum Essential Coverage (MEC), Minimum Value (MV), and self-insured plans. If you are unsure what Minimum Essential Coverage, Minimum Value, or self-insured plans are, please refer to the glossary at the end of the article.

The audit is a two-part process. A one-click report will be utilized to audit plan names, premiums, and contributions. Specific system configuration screens will be used to audit MEC, MV, and self-insured settings.

Open Benefit Premium / Rate Configuration – Annual** Report

  1. From the menu, expand Settings and click Benefit Management.

    Medical_Benefits_-_04.1.png

  2. Click the benefit package associated with the current tax year.

    Medical_Benefits_-_01.png

  3. Click the Review Configuration tab.

    Medical_Benefits_-_02.png

  4. Click the Excel icon for the "Benefit Premium / Rate Configuration - Annual**" report.

    Medical_Benefits_-_03.png

  5. Confirm medical plan premiums and contributions.

Confirm MEC, MV, and Self-Insured Settings

  1. From the menu, expand Settings and click Benefit Management.

    Medical_Benefits_-_04.1.png

  2. Click the benefit package associated with the current tax year.

    Medical_Benefits_-_01.png

  3. Click the Configure Benefit Structure tab.

    Medical_Benefits_-_04.2.png

  4. Click on the individual medical plans.

    Medical_Benefits_-_04.png

  5. From the "Properties" tab, scroll down to the section labeled "Select from the Additional Options below if applicable"
    • If the medical plan is self-insured, check the box for "This plan is Self Insured"; otherwise, leave the box unchecked.
    • If the plan meets MEC, check the box for "This plan meets Minimum essential coverage (MEC) as defined by the ACA"; otherwise, leave the box unchecked.
    • If the plan meets MV, check the box for "This plan meets Minimum Value as defined by the ACA"; otherwise, leave the box unchecked.
    Medical_Benefits_-_05.png

Medical Benefit Elections

To ensure all benefit eligible employees have recorded medical elections (including waive, if applicable) with accurate dates of coverage.

All benefit eligible employees should have medical benefit elections recorded in InfinityHR. For self-insured medical plans, dependent enrollment (including dependent’s SSN and date of birth) also must be recorded.

Open Export Benefit Census Report

This report can be used to confirm employee medical elections and effective dates of coverage

  1. From the menu, expand Data, expand Exports, and click Manage.

    Employee_Quick_Excel_-_00.png

  2. Hover over "Quick Excel Exports" and click Export Benefit Census.

    Medical_Benefits_-_07.png

  3. Filter the data in the "Package Name" column (Column E) and in the "Benefit Name" column (Column F) to display the medical benefits for the correct year.

    Medical_Benefits_-_08.png

  4. Confirm the effects dates of the "Coverage" column (Column J) for each employee.
  5. If you find any missing and/or incorrect data for an employee, you can correct this in the affected employee's benefits screen.

    Medical_Benefits_-_08.1.png

  6. From the menu by expanding Employee, expanding Benefits, and click Benefits.

ACA Settings

To confirm the configured measurement periods are accurately tracking employees’ hours of service.

The Measurement Period is the period during which you track employees’ hours of service. The hours worked during this period will determine whether an employee is considered “full-time” qualified during the subsequent stability period. Ongoing employees are tracked using a standard measurement period and new hires are tracked using an initial measurement period.

Each configured measurement period being used to track employees’ hours of service must be ‘active’.

Confirm Measurement Period is Properly Configured

  1. From the menu, expand Settings and click Affordable Care Act.

    Medical_Benefits_-_00.png

  2. Click Settings from the top menu bar.

    ACA_-_01.png

  3. While the "Settings" tab is selected, click the measurement period name under the "Measurement Setting" column.

    ACA_-_02.png

  4. Ensure all required fields are correct.

    ACA_-_03.png

  5. Ensure the "Active" checkbox if checked.

    ACA_-_03.1.png

  6. If needed, create a new measurement period from "Settings" tab by using the Actions drop-down menu and clicking Create Period.

    ACA_-_04.png

Confirm Measurement Period for Benefit Eligible Employees Is Working Per Configuration

  1. From the menu, expand Employee, expand Benefits and click ACA Profile.

    Enter_Missing_Data_-_00.png

  2. While viewing the Measurement Periods tab, confirm that the measurement period calculation for the most recent tax year.

    ACA_Profile_-_04.png

  3. If multiple measurement periods exist, test each measurement period by isolating an employee for each eligibility rule used.

Generate Measurement Period for All Benefit Eligible Employees

  1. From the menu, expand Settings and click Affordable Care Act.

    Medical_Benefits_-_00.png

  2. Click Utilities from the top menu bar.

    ACA_-_07.1.png

  3. Enter the Measurement Period Effective date.

    ACA_-_07.2.png

  4. Click the radial button for "Generate Measurement Periods."

    ACA_-_07.3.png

  5. Select the measurement period to generate.

    ACA_-_07.4.png

  6. Click Execute Utility.

Hours of Service

Hours worked of all non full-time employees must be tracked in InfinityHR to determine if medical benefits should be offered. An employee is considered fulltime from an ACA perspective if he works at least 30 hours in a week or 130 hours per month

Confirm Employee Hours

Confirm hours worked for recorded for all part-time, variable, and seasonal employees.

  1. From the menu, expand Employee, expand Time and Labor Mgmt, then click Time and Attendance.

    Hours_Service_-_00.png

OR

  1. From the menu, expand Settings, expand Time and Labor Mgmt, then click Time and Attendance.

    Hours_Service_-_01.png

  2. Click Step 3 - Review Timesheet Cards.

    Hours_Service_-_02.png

Import Time Records for Employe's Missing Recorded Hours

Setup Project Code

  1. From the menu, expand Settings, expand Time and Labor Mgmt, then click Time and Attendance.

    Hours_Service_-_01.png

  2. Click Settings from the top menu bar.

    Hours_Service_-_03.png

  3. Click the Project Management tab.

    Hours_Service_-_05.png

  4. Enter a name for the project into the "Project Category" field, then click Save.

    Hours_Service_-_06.png

Create a Project

  1. While viewing the "Project Management" tab, click the Projects tab.

    Hours_Service_-_07.png

  2. From the Actions drop-down menu, click Create Project.

    Hours_Service_-_08.png

  3. Enter a project code and name as required.
    • Please Note: Project code will be used on the TImesheet Date Import.
    Hours_Service_-_09.png

Import Timesheet Data

  1. From the menu, expand Data, expand Imports, and click Standard.

    Enter_Missing_Data_-_03.png

  2. From the "Import Type" drop-down menu, select Timesheet Data.
    • For information how to format the timesheet, click Import Layout.
    Hours_Service_-_12.png
  3. Click Browse to select the file to import and enter the worksheet name.

    Hours_Service_-_13.png

  • Click Import File.

Repeat

  1. Repeat the "Confirm Employee Hours" step.

Generating Forms

  1. From the menu, expand Settings, and click Affordable Care Act.

    Generating_-_00.png

  2. Click Forms in the top menu bar.

    Generating_-_01.png

  3. Enter the following information:
    • Select the reporting year of the forms you will be generating.
    • Enter a contact name and phone number.
    • Select the employer to generate the form.
    • Select an offer method and any other additional options.
    • To give Arcoro consent to file, check the box for "Is this the Authorative Transmittal for the ALE Member?"
    Generating_-_02.png
  4. Click Generate.

Aggregated ALE Group Reporting

Applicable Large Employer (ALE) is an employer with 50 or more full-time employees or full-time equivalents on business days during the preceding calendar year.

  • When generating your forms, check the box for "Aggregate ALE Group".

    ALE_Group_-_00.png

  • Once checked, a modal window will appear like below where you can:
    • Specify Aggregated Indicator Month(s): Used to specify which months the selected employer was part of the Aggregated ALE Group.
    • Specify ALE Group Members: Used to specify which employers are included in the Aggregated ALE Group.
    ALE_Group_-_01.png
  • Any selections made for the "Aggregated ALE Group Details" modal will be used to fill in Part III and Part IV of the 1094-C form.

    1094_-_04.png

  • Enabling the "Aggregated ALE Group" checkbox will also select the "Yes" box on Part II, Line 21 of the 1094-C form.

    1094_-_01.png


Reviewing Forms

After generating your forms, review them to protect your organization from inaccuracies and prevent post-filing corrections.

High Level Review

Some things to check for at a high level:

  • Confirm Employees Last Names (Sorted A thru Z)
  • Each 1095 form is 3 pages long, so the total number of pages divided by 3 should equal the number of employees you are reporting for.
    • If you included a one-page employee mailer, then you will have 4 pages per employee.

Audit_-_High_Level_1.png

Granular Review

Some things to check at an audit level:

  • On the left side of the 1095C is the employee data and the right hand side is employee infomration.
    • Make sure that the information is correct.
    • Confirm the address and EIN is correct.
    • Toward the bottom will be specific tax codes for each employee.

Audit_-_Granular.png


Correcting Data

Common Errors for Forms

Company Information

A common error found for the employer settings are incorrect company names or EIN.

  1. From the menu, expand Setup then click Setup Properties.

    Employer_-_00.png

  2. Hover over General and click Employers.

    Employer_-_01.png

  3. Click the name of the employer.

    Employer_-_04.png

  4. Ensure that you are using the legal business name, not a "Doing Business As" (DBA), and the correct EIN. If either is incorrect, the transmission to the IRS will fail.

    Employer_-_05.png

Employee Information

Some of the most frequent errors are found within the employee's demographic.

  • To begin, use the top search bar to pull up the affected employee's profile.

    Employee_Search_-_00.png

Personal Information

While viewing the employee's profile, hover over Employee and click Demographic Info.

Employee_-_Demographic_Info_-_01.png

From the employee's "Personal" tab, double-check the following:

  • Misspelled First and/or Last Name
  • Incorrect Social Security Number (SSN).

Employee_Info_-_01.png

Employee Information

From the employee's "Employee" tab, double-check the following:

  • Employee Status
  • ACA Status
  • Benefit Status
  • Hire Date
  • Benefit Eligibility Date
  • Termination Date

Employee_Info_2_-_02.png

Employee Status History

  1. While viewing the employee profile, go to Benefits and click ACA Profile.

    Employee_-__ACA_Profile_-_01.png

  2. Click the Employee Status History tab.

    Employee_Status_History_Tab_-_00.png

  3. Make any adjustments to the employee's status history.

    Employee_Status_History_-_00.png

Medical Benefits

<Need Steps>

Medical_Benefits_-_00.png

Importing Data Corrections and Code Overrides

  1. To adjust 1095s using Excel, ensure that you download the Raw Data file. This will allow you to import your saved changes. 

    Importing_-_03.png

  2. When importing an updated 1095-C file, you will enter the following steps as if you are generating the file from scratch prior to uploading the file.
    1. Enter the reporting year.
    2. Enter the contact name and phone number.
    3. Select the Employer
    4. Select the Employee Group
    5. Select the appropriate Offer Method
    6. Select the applicable options
    Importing_-_04.png
  3. To see the option to load an updated date filed, click the checkbox for "Load Data from File" found under the "Please select from all that apply to this transmission" section.
    • Enabling this may take you to the "View Completed Forms" tab. Return to the "Generate Forms" tab if this occurs.

    Importing_-_05.png

  4. To import the new file, click Browse, select the appropriate data file, and enter the "Worksheet Name" that the data resides on.

    Importing_-_06.png

  5. Click Generate.

Submission History

  1. From the menu, expand settings then click Affordable Care Act.

    Generating_-_00.png

  2. Click Forms from the top menu bar.

    Generating_-_01.png

  3. Click the Submission History tab.

    Submission_History_-_01.png

  4. Use the filter icon to view forms for specific employers.

    Filter_Icon.png


Frequently Asked Questions

  • Can I accept the IRS filing status of "Accepted with Errors"?
    • Ultimately this decision is up to you.
    • Accepted with Errors indicates that there was no rejected data within the return, but there is at least one record within the return presenting an error.
    • In general, the IRS expects that there is at least an attempt to resolve these errors.

Glossary

Minimum Essential Coverage (MEC)

MEC is defined by Healthcare.gov as any insurance plan that meets the Affordable Care Act requirement for having health coverage. To avoid the penalty for not having insurance for plans 2018 and earlier, you must be enrolled in a plan that qualifies as minimum essential coverage (sometimes called “qualified health coverage”). Starting with the 2019 plan year (for which taxes are filed in April 2020), the penalty no longer applies.

Minimum Value (MV)

Healthcare.gov defines MV as a standard of minimum coverage that applies to job-based health plans. If an employer’s plan meets this standard and is considered “affordable”, an employee will not be eligible for a premium tax credit if he buys a Marketplace insurance plan instead. A health plan meets the MV standard if both of the following apply: -The health plan is designed to pay at least 60% of the total cost of medical services for a standard population -Its benefits include substantial coverage of physician and inpatient hospital services

Self-Insured

Self-insured health plans are usually present in larger companies where the employer collects premiums from enrollees and takes on the responsibility of paying employees’ and dependent’ medical claims. Employers can contract for insurance services such as enrollment, claims processing, and provider networks with a thirdparty administrator, or the employer can self-administer the plans themselves.

Was this article helpful?
0 out of 0 found this helpful