ACA Data Review Guide

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This is the beginning of the ACA printing, delivery, and filing process.

Self-Funded Plans
For those with self-funded/self-insured plans:

  • Make sure your plans are checked as “Plan is Self-Insured”
  • You must have the covered dependents in the system with their Social Security # and Date of Birth.
    Date of Birth can only be used by itself if the Social Security number cannot be obtained with "a reasonable effort".
  • These dependents and spouses must also be attached to the medical plans that they are covered
    under.
  • You must also report employees enrolled in coverage who are not Full-time employees,
    including their dependent & spouse information if covered.
  • You must also report those on COBRA, including dependent & spouse information if covered.

ACA Contact Information
Complete your ACA Form Contact Information:

Company contact information will need to be verified and updated if necessary


Settings > Global Setup > Company Setup > ACA Tab
If the ACA tab is not visible, please contact your Account Manager for assistance.

 

Reviewing Employees for 1095-C Creation

Use the attached Data Review Checklist that accompanies this message

1. ACA Setup Review

My Info > My Reports > My Saved Reports > ACA Setup Review

**To see this report check the box Show Others’ Settings and search for the report by Choosing ‘like’ and typing “ACA” in the Saved as Name.

Use the included Data Review Checklist to view this report for Benefit Profiles and ACA Profiles
for Active and Terminated Employees during the calendar year.

  • Full Time Hourly or Salaried Employees - They MUST have BOTH a Benefit Profile and ACA Profile. Even if they have waived coverage. 
  • Part-Time Employees - Must have an ACA Profile. If you offer Benefits to Part-Time Employees they
    should also have a Benefit Profile.
  • Non-Employees/1099/International/System Admins/Test/Not in Payroll – Must have an ACA Profile marking them as Non-Employees. This will prevent them from being counted as employees on the 1094-C form during filing.

If employees are missing these items you will need to make the appropriate modifications.

If an Employee does not have an ACA profile, the system will not be able to create 1095-C data or a 1095-C form.

2. Check that the terminated employee’s benefit coverage has been end-dated.

Team > Benefits > Benefit Plans
You can click on the Add/Remove Columns and bring in any additional columns that may be beneficial
to you.

Bring in the below columns:

  • Employee Date: Terminated
  • Coverage Effective From
  • Coverage Effective To


Filter the EMPLOYEE STATUS field to “= terminated” and the Date Terminated to “>= 01/01/2022”
When doing this you only need to look at your medical plans. Look over the 2022 terminations making
certain that the Coverage Effective Date is accurate based on the terms of your plan (i.e. Coverage
was end-dated at the end of the month or day of termination). Look especially for plans with the Coverage Effective to Date of 12/31/9999. Make all necessary adjustments to the employee.

3. ACA Recalculation and Data Summary check for compliance alerts

It is best at this time to recalculate your ACA Data, this can take a while to complete so plan to
run it while you will not need your computer. This will recalculate and apply all changes that you
have made up to this point.


Team > HR> ACA > ACA Employee Actions If you have a large number you may want to run this in 2
passes. 1.) with your active employees and 2.) with the years terminations. This will avoid
calculating terminated employees who did not work for you before this reporting year.

Select All and then click Recalculate. A message will pop up where you will click on the Recalculate
button leaving the year to the default.

 

Team> HR> ACA > ACA Data Summary
This report shows you if you have Compliance Alerts.

This will bring up all the Employees with Compliance Alerts. Click the pencil next to the Employee.


This will bring up the 1095-C. Click the Info link under the month with the caution sign.


Scroll to the bottom and look for Compliance Alert. Here you are told why this employee has a
compliance alert, the alert should be investigated and corrected if possible.

If corrections are made the Employee can be recalculated and the alert may be removed, as long as
the compliance alert is not a true alert. A Compliance Alert does not mean that you will receive a
fine it means that the system sees something that needs your attention and the potential for a fine
may exist.

To Recalculate:

Team > My Team > Employee Information > Choose your Employee > ACA Tab > ACA Timeline Overview >Manage Employee’s ACA Timeline. Click on Recalculate in the Upper right of the screen

Common Reasons for Compliance Alerts:

  • The employee is Full-time but does not have a benefits plan assigned to them or a waived plan.
  • The employee is Full-time but does not have a Benefit Profile assigned to them.
  • The employee’s Benefit Profile is not properly dated (The date when coverage becomes active, not the date offered)
  • The Employee is considered full-time for the current stability period, but benefits were
    removed.
  • The plan is considered not affordable by ACA guidelines
  • The employee was not offered benefits and is considered Full-time by ACA guidelines (Average 130hrs per month)