Eight Steps to Affordable Care Act Compliance

October 2018 | Article

For the past five years, businesses have been asking the same question: what do I need to do to comply with the Affordable Care Act? The following outlines some key things to consider as you work to avoid costly ACA penalties:

  1. All businesses should review their prior calendar year employee count to determine if they are considered an Applicable Larger Employer (ALE), which is defined as an employer with 50 full-time equivalent employees or more. This number is important as your current year compliance filings are dependent on your prior year count. Remember to consider related entities.
  2. Do you have a self-funded insurance plan? If so, you have a filing requirement regardless of your size.
  3. ALEs: are you using the monthly or lookback measurement period? Be sure to document your measurement method and file your 1095-C forms using that method.
  4. Gather employee hours according to the measurement period you are using to verify each employee’s status.
  5. Collect and file insurance waivers in case of an ACA audit.
  6. Review insurance premiums and 1095-C coding to verify which codes to use on the forms.
  7. Remember to complete forms for all twelve months of the year; do not leave a month blank unless you are using the “All 12 Months” column.
  8. Contact your Eide Bailly professional for assistance in completing the ACA compliance forms or to review your work. Be sure to do this prior to submitting that information to the IRS.

After a few years of helping clients complete or review ACA required filings, including responding to IRS “Pay or Play” penalty letters, we have found a few common errors that cause problems in form completion:

  • Using conflicting codes on lines 14 and 16.
  • Not filling out all of the appropriate lines on the forms, especially line 16, which is often missed.
  • Completing forms for non-full-time employees in the case of a fully insured plan.
  • Completing forms for non-full-time employees of self-insured plans who are not enrolled.

Rules surrounding the ACA continue to change; however, your Eide Bailly ACA team keeps up with the changes and is here to help. Contact your Eide Bailly professional or a member of our ACA team with questions or to learn more.

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