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?
- If not, do you want to offer health insurance?
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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!
