Employer Reporting Requirements under ACA By: Arthur Tacchino, JD Chief Innovation Officer SyncStream Solutions, LLC.

Employer Reporting Requirements under ACA

By: Arthur Tacchino, JDChief Innovation Officer SyncStream Solutions, LLC

• Code §6056 – Applicable Large Employer and

Offering Employer Reporting

• Code §6055 – Reporting for Employers that

Self-Insure

• W-2 Reporting

Reporting Requirements

§ 6056 Reporting

• Effective beginning in 2015 – Delayed 1 Year

– Early voluntary compliance is acceptable

• “Applicable Large Employers” must report, whether

they offer coverage or not

– An employer that employed 50 or more full-time

equivalent employees in the preceding year

– Controlled group rules apply for determining A.L.E.

Status*

A.L.E. Status• Each Month throughout 2014:

– Identify full-time employees

– Aggregate hours of service by anyone not full-time

– Divide aggregate hours of service by 120

– Add the number of full-time employees to the

number of equivalent employees to determine the

average number of full-time equivalent employees

the employer employed that month

Example• January 2014

– 45 full-time employees

– 15 part-timers that worked 1,200 hours

throughout the month

– 1,200 aggregate hours / 120 = 10 equivalent

employees

– 10 equivalent employees + 45 Full-time employees

= 55 Full-Time Equivalent Employees

When does employer report?

• The actual report will be much like W-2

reporting

• By January 31st of the following year

• Practically speaking the report would be

delivered in January of 2016 with 2015 plan

information

What does employer report? • the employer’s name, date, and employer identification number (EIN);

• a certification of whether the employer offers its full-time employees and their

dependents the opportunity to enroll in “minimum essential coverage” under an

eligible employer-sponsored plan

• the number of full-time employees the employer has for each month during the

calendar year;

• the name, address, and taxpayer identification number (TIN) of each full-time

employee employed by the employer during the calendar year and the months

(if any) during which the employee and any dependents were covered under a

health benefit plan sponsored by the employer during the calendar year; and

• any other information required by the IRS

The statute also requires that employers that offer the opportunity to

enroll in “minimum essential coverage”

• must also report the months during the calendar year for which

coverage under the plan was available;

• the monthly premium for the lowest-cost option in each of the

enrollment categories under the

• plan;

• the employer’s share of the total allowed costs of benefits provided

under the plan; and

• in the case of an employer that is an applicable large employer, the

length of any waiting period with respect to such coverage

Who gets a report? • The employer is responsible to furnish a report for the

IRS, as well as a statement to their full-time employees

which includes:

– the name, address, and contact information of the reporting

employer; and

– the information required to be shown on the return with

respect to the individual

• *Currently the IRS is trying to “simplify” reporting

Penalties for Noncompliance• Employer becomes subject to penalties for failure to

file an information return and failure to furnish payee

statements

• Employer shall pay a penalty of $100 for each

statement with respect to which such a failure occurs,

but the total amount imposed on such employer for

all such failures during any calendar year shall not

exceed $1,500,000

§ 6055 Reporting

• Effective beginning in 2015 – Delayed 1 Year

– Early voluntary compliance is acceptable

• Code § 6055 requires insurers, sponsors of self-

insured plans, and other entities that provide

minimum essential coverage to an individual

during a calendar year to comply with this

reporting requirement

When does employer report?

• The actual report will be much like W-2

reporting

• By January 31st of the following year

• Practically speaking the report would be

delivered in January of 2016 with 2015 plan

information

What does employer report? • the name, address, and taxpayer identification number (TIN) of the primary

insured,65 and the name and TIN of each other individual obtaining coverage

under the policy;

• the dates during which the individual was covered during the calendar year;

• if the coverage is health insurance coverage, whether the coverage is a qualified

health plan (QHP) offered through a health benefit Exchange;

• if the coverage is health insurance coverage and that coverage is a QHP, the

amount of any advance cost-sharing reduction payment or of any premium tax

credit with respect to such coverage; and

• any other information required by the IRS

In addition, under the statute, if health insurance coverage is through

an employer-provided group

• health plan, the return must contain the following information:

• the name, address, and employer identification number (EIN) of the

employer maintaining the plan;

• the portion of the premium (if any) required to be paid by the

employer; and

• any other information the IRS may require to administer the new

tax credit for eligible small employers under Code § 45R

Who gets a report? • The employer is responsible to furnish a report for the

IRS, as well as a statement to their full-time employees

which includes:

– the name, address, and contact information of the reporting

employer; and

– the information required to be shown on the return with

respect to the individual

• *Currently the IRS is trying to “simplify” reporting

Penalties for Noncompliance• Employer becomes subject to penalties for failure to

file an information return and failure to furnish payee

statements

• Employer shall pay a penalty of $100 for each

statement with respect to which such a failure occurs,

but the total amount imposed on such employer for

all such failures during any calendar year shall not

exceed $1,500,000

Measurement, Administrative, and Stability Periods

• These new tracking requirements will dictate,

who is “full-time”, therefore, who should be

offered coverage

• Systems must be put in place

W-2 Reporting

• Became effective in 2012

• 250 W-2 Exemption still in place

• Employers required to report the aggregate

cost of employer sponsored coverage on the

employee’s W-2

• Still informational only reporting

Utilize Resources

• ACA Decision Support Tool

• ACA Dashboard

• Subsidy Determinator

• SyncACA

Q & A

Visit us at www.sync-stream.com

Call: 877-291-9256

Email: [email protected]