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PPACA Compliance Checklist
Counting to 50 FTE's
 Reporting for 2022 Due in 2023

For the first time in the past several years, the actual reporting forms have been updated to include the Zip Code by month for each employee as well as the employee's age on January 1st of the Reporting Year.  These updates as well and several new Safe Harbor Codes further complicate the reporting process for 2020 and forward.

Some of the provisions of the Affordable Care Act, or health care law, apply only to large employers, generally those with 50 or more full-time equivalent employees. For example, in 2015 and forward large employers will have 
annual reporting responsibilities concerning whether and what health insurance they offered to their full-time employees.

 Coverage
  • If you have 50 or fewer employees, you can purchase coverage for the benefit of employees or send them to the Marketplace.
  • Small employers are barred from pre-tax premium assistance to employees and are still required to mail Marketplace Letters to every new hire within 14 days of their start work date.
  • To learn more about market reforms and various plan requirements, visit HealthCare.gov.
  • Or you can rely on a trusted licensed benefit broker who can work with MoneyWise Solutions, Inc. to tie up all these loose ends toward compliance. 
  • Effective for calendar year 2015 and forward, if you provide self-insured health coverage to your employees, you must file an annual return reporting certain information for each employee you cover. This rule was optional for 2014.
  • Or you can rely on a trusted licensed broker who can work with MoneyWise Solutions, Inc. to tie up all these loose ends for reporting and help achieve total compliance.
To begin this process, please complete the forms below ... Part 1 and Part 2.

We have a 2 Step Process to get you past the worries of PPACA Compliance with the rules related to 1094-C and 1095-C filing for each year.

Step 1
E-mail us and tell us that you are ready to start along with your capability to complete and provide accurate information outlined in the MoneyWise provided spreadsheet template.

Step 2
We will schedule a short conference call if needed, (15 minutes or so) to verify and collect the balance of information we need to complete the 1094-C and 1095-C forms.  Additionally, we will agree to a date for processing which will be driven by our production scheduling and the availability of the spreadsheet information.

So, after we have all the information needed, you can have a date certain on our production schedule for when you can expect your 1094-C and 1095-C forms to be delivered.  

Here is what you get:
  • Timely and accurate 1094-C / 1095-C forms completed.  
  • 1095-C's will be mailed 1st class mail and a certificate of mailing will be generated at the time they are posted.
  • PDF images of each individual form produced filed on our secure FTP cloud server with direct client access on request.
  • E-mail confirmation when the forms are mailed.
  • On Time Filing with the IRS.
  • Retention of all the related documents and forms for 5 years on our secure file server.
  • $700 Base and $10.50 per form. 
  • Self Funded Plans on Quoted Fee Only​.
  • Clients with 250 or more forms require electronic filing by the IRS ... the additional fee for this is $500. Extra fees may apply if requests for information are delayed more than two business days or initial information in good order.
  • Pricing is subject to change after December 10th each year.  These prices have been the same for 3 years.

Fully Funded Plans ONLY
Setup Form for ACA Reporting (Part 1 of 2)
Template for Fully Funded Plan Data (Part 2 of 2)

Self Funded Plans ONLY

Setup for Self Funded Plans (Part 1 of 2)
Template for Self Funded Plan Data (Part 2 of 2)

Pay or Play - Employer "Shared Responsibility Provisions"
Click Here to Ask Us a Question
Additional Background Information

The Coding for the 1095-C's has a wide range of options and it seems the rules are truly "written in the sand". The programmers have done a fantastic job of keeping up with these changes. Here are some "fun facts" about the filings for 1095-C and 1094-C's.
  • We are allowed and will omit the instruction pages from the IRS filing and from the mailing to client employees.
  • For fully funded plans, Part III will be totally left blank. This information will be provided to the IRS by the benefit insurance carrier of record on the Form 1095-B.
  • On most 1095-C's most of the boxes in Part II will be blank. One example is an employee that was employed for all 12 months of calendar 2019 and was offered coverage that was compliant with the PPACA and was deemed affordable, only the 12 months box will be marked with the code 1A.
  • MoneyWise will mail the 1095-C's to client employees as soon and they exit the print queue. If an error, address change, or other changes are required, we will make those updates as soon as possible. The employee mailing deadline is February 28, 2023.
  • Paper Filing with the IRS deadline of February 28th will be done in February before the deadline. Electronic Filing for clients with over 250 forms is required by the IRS and an additional fee is required. The electronic filing deadline with the IRS is March 31st.
  • If clients receive copies of the Insurance Carrier generated 1095-B, it would be helpful if we were provided an electronic copy of those forms as soon as they are received.
  • Please pay special attention to Columns I and J on the spreadsheet template. If Benefit Start Date is left blank, we will assume that coverage was waived.
  • If your plan is "self funded", the attached spreadsheet is NOT the correct template for your plan. Please contact MoneyWise immediately to receive the correct template for "self funded" plans and the related quoted fee.
  • Re-mailing due to data changes after the employee mailing will be $6 per form. If the mistake is ours, these are done free of charge.
  • If an edit that makes a substantive change in a filing is requested after the package to the IRS has been sent, a corrected filing is required. IF that change is due to our error, this will be done free of charge. If it was incorrect data provided by the client the fee will be $100 per filing.
  • Coverage
  • If you have 50 or fewer employees, you can purchase coverage for the benefit of employees or send them to the Marketplace.  Small employers are barred from pre-tax premium assistance to employees and are still required to mail Marketplace Letters to every new hire within 14 days of their start work date.  To learn more about market reforms and various plan requirements, visit HealthCare.gov.  Or you can rely on a trusted licensed benefit broker who can work with MoneyWise Solutions, Inc. to tie up all these loose ends toward compliance.

Reporting
You must withhold and report an additional 0.9 percent on employee wages or compensation that exceed $200,000. You may be required to report the value of the health insurance coverage you provided to each employee on his or her Form W-2.  Effective for calendar year 2015 and forward, you must file an annual return reporting whether and what health insurance you offered your employees. This rule was optional for 2014.  It is required to report for an entire year following a year that the total Full Time Employee Equivalent head count exceeded 50 for more than half of the preceding year.  Effective for calendar year 2015, if you provide self-insured health coverage to your employees, you must file an annual return reporting certain information for each employee you cover. This rule was optional for 2014.  Or you can rely on a trusted licensed broker who can work with MoneyWise Solutions, Inc. to tie up all these loose ends for reporting and help achieve total compliance.

Thanks for allowing us to serve your ACA / Benefit Administration needs!
Please e-mail or call with questions.