Affordable Care Act Compliance and “Pay or Play” Penalty Letter Example

September 2018 | Article

Since the Affordable Care Act (ACA) became reality, businesses have been scrambling to figure out what compliance looks like and how best to comply. Then when they find themselves in trouble, they worry about how to respond to the IRS. We can help reduce that worry, as we did recently for a client facing an ACA compliance penalty notice.

Million Dollar Penalty
The client had received an IRS Letter 226J that assessed a $1.1 million penalty. After reviewing the client information, we responded to the IRS and provided back-up documentation for the year 2015 including:

  • Insurance plan offerings
  • Insurance waivers
  • Termination documentation
  • Affordability calculations
  • Employee hours worked
  • Applicable transition relief applicability

Based on the information provided, and our involvement in the presentation of those materials, the IRS abated the entire penalty for the year 2015.

Incorrect Filings
As a result of the abatement for the year 2015 forms, we were hired to review subsequent year’s filings that had been completed by the client.  We determined that every 1095-C form that they filed for 2016 was filed incorrectly. 

Rather than just redoing the 2016 ACA filings, we worked with the client to help them understand the IRS rules and then amended their 2016 and 2017 forms with the IRS, so that the client could avoid receiving penalty Letter 226J for 2016, 2017 and future years.

We Are Your ACA Resource
When you work with us to comply with 1094/1095 filing requirements, we can do everything from A to Z to ensure compliance, or just those parts that you are uncomfortable handling. The choice is yours, but compliance is a must. Contact your Eide Bailly professional or a member of our Health Care Reform team to learn more.

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