Part 6 – Identify Covered Individuals and Gather Information for Form 1095-C

For self-insured plans, you’ll need to identify covered individuals (employee, spouse, and their dependents) and their social security numbers. A date of birth will work in lieu of a social security number if you’ve made a reasonable attempt to gather SSNs.

Keep in mind that self-insured coverage is defined as coverage where the employer assumes the financial risk for providing health care benefits to its employees. This coverage is rare for small businesses since it is typically costly.

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Part 5 – Determine a Contact Phone Number for Form 1095-C

Probably one of the easier parts of the ACA preparation process, you will need to make sure your employees have a good contact number to reach you if they have questions about their Form 1095-C.

Since the Form 1095-C is sent to every eligible employee, you’ll want to make sure you use a contact number that is reachable during business hours, and (for large companies) make sure that it is adequately staffed to answer any questions your employees may have.

 

Part 4 – Determine Which Affordability Safe Harbor to Use

Perhaps one of the more complex pieces of the ACA compliance equation is the affordability safe harbor provisions.

At its simplest, coverage is considered affordable if the premium constitutes less than 9.5% of the household income of an eligible employee. Since this calculation takes into account the take home pay for spouses, it is often difficult (if not impossible) for a large employer to make this calculation, so the IRS has provided 3 alternative calculations that they refer to as affordability safe harbors.

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