Affordable Care Act

Updated 12/15/15

Affordable Care Act

Helpful Links for additional info

ACA Q&A (IRS) 1094-C and 1095-C Forms

ACA - Employers Info (IRS)

Form Instructions (IRS)

July IRS webex - Employer Reporting

Electronic Filing

Affordable Care Act Information Returns (AIR) Program

Links to additional resources and webinars

Applying for a TCC (Transmitter Code)

Meditech Product and Resources Pages

Readiness Checklist

50+ Full Time Employees

2016 based on Calendar Year 2015

Reporting Criteria

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The type of coverage an individual needs to have to meet the individual responsibility requirement under the Affordable Care Act. This includes individual market policies, job-based coverage, Medicare, Medicaid, CHIP, TRICARE and certain other coverage. -HEALTHCARE.GOV

Reporting Forms and Information

Employee Form

Form 1095-C (2014) Form 1095-C (2015 Draft) Form 1095-C (2015 Final 9/17/15)

Employer Form

Form 1094-C (2014) Form 1094-C (2015 Draft) Form 1094-C (2015 Final 9/17/15) Note: Employer reporting will be done electronically. 1094-C paper forms will not be needed. This is an example of the data that will be included in the e-file.

Any Questions?

Unique Considerations

Monthly Reporting Payroll is not usually monthly but rather bi-weekly. To account for the monthly requirements with employees’ hours, employees hours will be accrued similar to month end accrual calculations (ie days in pay period/days left in month).

Flexibility for different use of earnings or employee type etc. to determine full time status.

Dependent Information must be entered for self-insured hospitals. Dependent information will flow from the employee file to the ACA record. Must define either a social security or date of birth.

Quick reference for ACA routines - MAGIC

● Magic Workstation 4.x○ Dictionaries

■ Dictionaries A-M → Enter/Edit Dictionary Menu → ACA Menu○ Process Routines

■ Employee Maintenance → Employee ACA → Employee ACA Data Enter/Edit, List,

Employee-Dependent Upload■ Quarter and Year End Menu → Year End → Affordable Care Act → Compile ACA

Employee Data List, List Compiled ACA Employees, Mass Edit, List Mass Edit Exceptions

● Magic Workstation 3.x○ Dictionaries

■ 90. Dictionaries → 1. Enter/Edit Dictionary Menu → 40. ACA Menu○ Process Routines

■ 20. Employee Maintenance → 20. Employee ACA → 11. Employee ACA Data Enter/Edit, 12. List, 13. Employee-Dependent Upload

■ 70. Quarter and Year End Menu → 50. Affordable Care Act → 11. Compile ACA

Employee Data List, 12. List Compiled ACA Employees, 13. Mass Edit, 14. List Mass Edit Exceptions

● C/S PP Standalone ○ Dictionaries

■ Payroll Dictionaries (A-M) → Affordable Care Act → ACA Menu → Applicable Large Employer Member, Applicable Large Employer Member Group, Affordable Care Act Code

■ Personnel Dictionaries → Affordable Care Act Type○ Process Routines

■ Personnel → Process Employees → Employee Payroll → Employee ACA → Employee ACA Data Enter/Edit, List, Load Employee-Dependent File

■ Quarter and Year End Menu → Affordable Care Act → Compile ACA Employee Data List, List Compiled ACA Employees, Mass Edit, List Mass Edit Exceptions

● C/S HR and Payroll○ Dictionaries

■ Payroll Dictionaries (A-M) → Affordable Care Act → ACA Menu → Applicable Large Employer Member, Applicable Large Employer Member Group, Affordable Care Act Code

■ HR Dictionaries (A-M) → Affordable Care Act Type○ Process Routines

■ HR → Employees → Employee ACA → Employee ACA Data Enter/Edit, List, Load Employee-Dependent File (5.66 release or below)

■ PP → Quarter and Year End Menu → Affordable Care Act → Compile ACA Employee Data List, List Compiled ACA Employees, Mass Edit, List Mass Edit Exceptions

Quick reference for ACA routines - Client Server

MEDITECH DictionariesPayroll

Earning Group Dictionary: Group earnings to include or exclude in the earnings calculation. Timecard or attendance data is used to add up service hours for full time determination.Applicable Large Employer Member (ALE): Employer Information for reporting purposes including EIN, Self-Insured Flag, and Payrolls.Applicable Large Employer Member Group: Listing of Applicable Large Employer Members (ALE) that are reporting together.Affordable Care Act Code: All the standard codes for ACA reporting and the line that the code will print.

Personnel/HRAffordable Care Act Type: User defined type to group employees together and assign codes.

ACA Payroll Dictionaries C/S

Routines -> Payroll -> Quarter and Year End

Magic Dictionaries

● Earning Group

● Affordable Care ActDictionary Menu

Earning Group Dictionary

Earning Group Dictionary: Group earnings to include or exclude in the service hours calculation. Timecard or attendance data is used to add up hours for full time determination. This is important if you need to evaluate service hours.

Applicable Large Employer Member (ALE): Employer Information for reporting purposes including EIN, Self-Insured Flag, and Payrolls.

Payrolls can only be grouped together if the EIN is the same.

Applicable Large Employer Member Group

Applicable Large Employer Member Group: Grouping of Applicable Large Employer Members (ALE) that will report together. The 1095-C forms

will still be produced under the individual ALE Member. This

ACA Code Dictionary

IRS Standard Indicator Codes

● Mnemonic/Code is the reporting code that will print on 1095-C form

● Name can be modified to meet your needs and are reformatted from the standard codes description to fit the line in the MEDITECH dictionary

● Name field does not print on any forms

● Line 14 and 16 are populated with Indicator codes

● Line 15 is a dollar value and only is required if Line 14 is 1B, 1C, 1D, 1E

ACA Indicator Code Name and Mnemonic IRS Standard ACA Indicator Codes

Line 15 value is only required with these Line 14 values

Affordable Care Act (ACA) Type Dictionary

HR/Personnel DictionaryAffordable Care Act Type: User defined type to group/categorize employees

together and/or assign default 1095-C codes.

Any Questions?

Payroll -> Quarter and Year End -> Affordable Care Act

Payroll -> Quarter and Year End Menu -> Affordable Care Act Menu

Compile ACA Employee Data

Compile Employee Information based on Include/Exclude Selections● A.L.E. or A.L.E. Member group● Select Group of Employees or Compiled Selection● Compiled from Timecard or Attendance Data● By Period (Monthly)● Include or Exclude Earnings Group

What is the compile ACA data used for?➢ Evaluate service hours to determine if you are making a qualified offer to all

the applicable employees➢ Group employees together for the purpose of mass editing

Compile routines to evaluate/group employees

Evaluate service hours based on earnings that are defined in the Earning Group Dictionary. The hours for employees are based on Timecard or MEDITECH Attendance data for a selected time period. The compile gathers the employees by including, excluding or pulling in a compiled selection. The employees from this compile can be broken down into user defined ACA type groups based on hours.

Evaluate service hours based on earnings that are defined in the Earning Group Dictionary. The hours for employees are based on Timecard or MEDITECH Attendance data for a selected time period. The compile gathers the employees by including, excluding or pulling in a compiled selection. The employees from this compile can be broken down into user defined ACA type groups based on hours.

MAGIC ACA EMPLOYEE COMPILE

List Routine allows review of the service hours for the compiled period for the selected average service hours. Review of the hours can assist in determining which categories could be assigned.

Mass Edit Routineallows editing for a particular period or across 12 months for the ACA type or the values for Line 14, 15, 16 and dependents

Populates from Compilation Selection

Dependent and employee health coverage prompts can also be mass edited with the same logic. All 12 months, certain months, and overwriting are options for adding the Y or N to the employee and dependent boxes for self-insured entities.

MAGIC ACA Mass Edit Routine

Mass Edit Routineallows editing for a particular period or across 12 months for the ACA type or the values for Line 14, 15, 16 and dependents

MAGIC ACA Mass Edit Routine

Dependent Mass Edit Screen

Dependent and employee health coverage prompts can also be mass edited with the same logic. All 12 months, certain months, and overwriting are options for adding the Y or N to the employee and dependent boxes for self-insured entities.

Mass Edit Exception File will list employees that were not able to be updated. This would standardly be due to the record being updated or lack of access for the user running the routine. Payroll and MIS access is respected with the compile and edit routine.

Located in Personnel or HR Menu

Individual Employee Edit of ACA InformationInformation can be adjusted on a per employee basis, per year, per ALE member

Self Insured Tab in the Employee Edit of ACA InformationAccessible only if the ALE Member Indicates Self Insured

Lists Employees and Dependents** Required Only if Self-Insured **

● Employee is listed first● Any dependents that were active in the employee file at the creation of the ACA

record● Dependents that are subsequently inactivated cannot be edited in the ACA record● Either Social Security Number or DOB is required. ● Social Security number or DOB can be updated here and will flow back to employee

file ● Each month that dependent is covered is noted or all 12 months.

Individual Employee Edit of ACA InformationInformation can be adjusted on a per employee basis, per year, per ALE member

Located on Employee Maintenance Menu

Self Insured Coverage page in the Employee Edit of ACA InformationAccessible only if the ALE Member Indicates Self Insured

Lists Employees and Dependents** Only Required if Self-Insured **

● Employee is listed first● Any dependents that were active in the employee file at the creation of the ACA record● Dependents that are subsequently inactivated cannot be edited in the ACA record● Either Social Security Number or DOB is required. ● Social Security number or DOB can be updated here and will flow back to employee file ● Each month that dependent is covered is noted or all 12 months.

COMPILE AND PRINT ROUTINES

1095-C

See Individual Presentation

Presentation

Dependent Upload Routines

Dependent Upload Specifications

C/S Human Resources and Payroll Dependent Upload Instructions

C/S Human Resources 5.67 Dependent Upload

MAGIC Dependent Upload Instructions

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Certifications of Eligibility

On the employer’s Authoritative Transmittal, Line 22 provides for certification of any “simplified reporting” method and/or Section 4980H employer mandate transition relief. Employers may select as many as apply from among the following:

A. Qualifying Offer Method

B. Qualifying Offer Method Transition Relief

C. Section 4980H Transition Relief

D. 98% Offer Method

What’s next?

● Evaluate your current benefit system with regard to ACA reporting○ How are your benefits offered?○ Time frame for offering benefits?○ Determine Protocol for New Hires/Terms/Variable Hours○ Determine standard process for Look back, Stability, and

Administrative periods.○ Create ACA types for categorizing employees○ Review the ACA Codes for applicability to your organization

● Determine parameters for compiled selections that will help you form ACA type groups for easier editing.

● If self insured, review dependent information in employee file.● Check the Product and Resources Page for documentation and any updated

information: MAGIC C/S

Evaluating Variable Hour Employees

● For ongoing employees who work a variable hour schedule, the employer can use a look back/standard measurement period to determine if an employee is considered full time for the purposes of meeting ACA requirements. The look back/measurement period can be as short as 3 months but no longer than 12 months.

● Administrative period is the period of time when the information is reviewed to determine classification and offer health coverage for the stability period. This administrative period can be up to 3 months in length.

● Once the average hours have been calculated, the employer can use this to classify the employee as FT or not for a stability period. The classification as determined in the administrative period must remain for the stability period even if hours are reduced. The stability period must be at least 6 months and at least as long as measurement period.

Additional Items

Phase 1 Delivery (12/2015):● Ability to compile employee data and print employee 1095-C forms

● W-2 changes to download file only

● FT prompt moving to monthly level for monthly FT count

Phase 2 Delivery (1/2016):

● Ability to compile and download electronic file for submission to government

Any Questions?