Insights: Article

2017 Affordable Care Act Update & Checklist

By Tonya Rule

November 08, 2017

Complying with the Affordable Care Act (ACA) can be confusing for businesses, but compliance is necessary to avoid steep penalties.

Below is a checklist for businesses to consider regarding their filing obligations and how to determine if they should request assistance in complying with the ACA. Our checklist provides a basic overview, but we know you might need more help. Many ALE’s (50+ FTEEs) or those offering self-funded insurance plans often need assistance completing the forms or are looking for someone to review their forms for errors to avoid costly penalties. 

Do you currently offer health insurance?

1. If not, do you want to offer health insurance?
    
2. If not, are you reimbursing for individual health insurance? 
   
   Note: If you are reimbursing for individual health insurance, you could be subject to a $100/day/person penalty. There is an exception that may apply if this reimbursement is done for one employee.
    
3. How many full-time employees do you have?
   
   Note: In 2017, ALEs (applicable large employers) need to offer affordable and adequate insurance to full-time employees or face potential penalties.
    
4. Do you have 50 or more full-time equivalent employees?
   
   Note: All ALE’s have a 1094/1095-C filing requirement. There’s a misconception that exists that insurance companies are filing these forms for businesses.
    
5. If so, are you covering 95 percent of full-time employees (FTEs)? 
   
   Note: In 2017, if offering insurance to less than 95 percent of FTEs, it’s treated as if no one was offered insurance. Therefore the “no insurance” penalty under code section 4980H(a) would apply.
    
6. Do you have any seasonal or part-time employees?
   
   Consider: Are they truly part-time or seasonal under the ACA? The rules for a seasonal employee are different than the rules for seasonal worker.
    
7. Is this a fully insured or a self-funded plan? 
    
   Note: Self-funded plans have a 5500 and1095 B or C filing requirement, regardless of size.
    
8. Is a written health insurance plan in place? 
    
   Note: All plans need a legal plan document in place. 

Contact your Eide Bailly professional or a member of our Health Care Reform team if we can be of assistance. We look forward to working with you!