Information for Essential ACA

Transcription

1 ADP Workforce Now Maintaining Annual Reporting Information for Essential ACA Current Version Handout Manual Need support after training? To exchange tips and best practices with fellow users, get on Bridge an online community built exclusively for ADP clients. V ACA15 Copyright ADP, LLC

2 ADP Trademarks The ADP logo and ADP are registered trademarks of ADP, LLC. ADP Workforce Now is a registered trademark of ADP, LLC. The Bridge Sponsored by ADP & Bubble Talk Design is a registered trademark of ADP, LLC. ADP A more human resource. SM is a service mark of ADP, LLC. Third-Party Trademarks All other trademarks and service marks are the property of their respective owners. Copyright ADP, LLC. ADP Proprietary and Confidential. All Rights Reserved. These materials may not be reproduced in any format without the express written permission of ADP, LLC. ADP provides this publication as is without warranty of any kind, either express or implied, including, but not limited to, the implied warranties of merchantability or fitness for a particular purpose. ADP is not responsible for any technical inaccuracies or typographical errors which may be contained in this publication. Changes are periodically made to the information herein, and such changes will be incorporated in new editions of this publication. ADP may make improvements and/or changes in the product and/or the programs described in this publication at any time without notice. Published by ADP Enterprise Learning March 2018

3 Any repurposing, reposting, or other use of this content (including but not limited to YouTube or any other social media) is expressly prohibited. Maintaining Annual Reporting Information for ADP Workforce Now Essential ACA Current Version [Subtitle] Just in Time. Just Enough. Just for Me. V ACA15

4 Audio You should be hearing the audio through your computer. If you do not have sound, check the volume settings. If difficulties continue, try pressing F5 to refresh your screen. You can also try switching your Internet browser to another browser, such as Mozilla Firefox or Google Chrome. 2

5 Questions and Answers 3

6 Resource List 4

7 Maximize Your Screen Maximize 5

8 Disclaimer This course does not provide the following: Legal advice The final word on the Affordable Care Act (ACA) A political opinion ADP is not a law firm and does not provide legal advice. Before taking any action on the information contained in this course, plan sponsors and employers should review this material with internal and/or external counsel. 6

9 Objectives Upon completing this webinar, you will be prepared to do the following: Describe how your data flows to ADP Health Compliance. Perform tasks in ADP Workforce Now to ensure that your ACA information remains accurate and current. Conduct a monthly audit of annual reporting forms in ADP Health Compliance. 7

10 ACA Data Maintenance Checklist 8

11 Tasks You Will Learn About Today Reviewing the Essential ACA Data Flow to ADP Health Compliance Pages Verifying Company Profile Data Completing ACA Compliance Attestations Setting Up and Reestablishing Measurement Periods Updating ACA Benefit Status Auditing ACA Data on ADP Health Compliance Pages Maintaining Self-Funded Medical Plans* *If your organization does not offer self-funded medical plans, you may exit the course before this topic. 9

12 Self-Funded versus Fully Insured Plans Fully Insured Plans The employer remits premiums to a third party benefits provider who administers the plan and assumes the risk for the associated plan costs like claims and claims administration. This is the most common option. Self-Funded Plans The employer assumes the total financial risk for the benefit plan, including actual paid claims, claims administration, and other administrative expenses. Employers that offer self-funded plans often outsource the claims administration function to a third-party administrator instead of addressing it in-house. 10

13 Form 1095-C: Fully Insured Plans 11

14 What Do You Think?? True or false: Maintaining your ACA data is important to ensure the accuracy of Forms 1094-C and 1095-C. a. True b. False 12

15 Why Is Maintaining ACA Data Important? Maintaining your ACA data throughout the year ensures that your ACA data remains accurate and current, which can help you avoid the following issues at year-end: Forms 1094-C and 1095-C populating missing or invalid data Form 1095-C not producing when expected Form 1095-C producing when it should not have IRS returning forms with errors IRS rejecting forms Manual edits and adjustments 13

16 Reviewing the Essential ACA Data Flow to ADP Health Compliance Pages Overview In this topic, we will discuss the overall flow of your employees ACA annual reporting data from data entry through your application to populate Forms 1094-C and 1095-C. 14

17 ACA Data Flow Using Essential ACA Enter employee ACA data in ADP Workforce Now. Benefit Offerings pages are populated. Review and correct any errors. Preview and approve Forms 1094-C and 1095-C on ADP Health Compliance pages. ADP files Forms 1094-C and 1095-C electronically with the IRS. Employees retain Form 1095-C for their records. Employees can view online (with ipaystatements only). Forms 1095-C are printed and delivered to you for you to distribute to your employees. 15

18 ACA Data Flow Using Essential ACA (cont.) Enter employee ACA data in ADP Workforce Now. Benefit Offerings pages are populated. Review and correct any errors. Preview and approve Forms 1094-C and 1095-C on ADP Health Compliance pages. ADP files Forms 1094-C and 1095-C electronically with the IRS. Employees retain Form 1095-C for their records. Employees can view online (with ipaystatements only). Forms 1095-C are printed and delivered to you for you to distribute to your employees. 16

19 ACA Data Flow Using Essential ACA (cont.) Enter employee ACA data in ADP Workforce Now. Benefit Offerings pages are populated. Review and correct any errors. Preview and approve Forms 1094-C and 1095-C on ADP Health Compliance pages. ADP files Forms 1094-C and 1095-C electronically with the IRS. Employees retain Form 1095-C for their records. Employees can view online (with ipaystatements only). Forms 1095-C are printed and delivered to you for you to distribute to your employees. 17

20 ACA Data Flow Using Essential ACA (cont.) Enter employee ACA data in ADP Workforce Now. Benefit Offerings pages are populated. Review and correct any errors. Preview and approve Forms 1094-C and 1095-C on ADP Health Compliance pages. ADP files Forms 1094-C and 1095-C electronically with the IRS. Employees retain Form 1095-C for their records. Employees can view online (with ipaystatements only). Forms 1095-C are printed and delivered to you for you to distribute to your employees. 18

21 What Do You Think? Essential ACA Data Flow? True or false: Once you enter data in ADP Workforce Now, the data populates employees ACA Benefit Offerings pages. a. True b. False 19

22 Topic Summary The data that you enter using Essential ACA will flow through your application to populate Forms 1094-C and 1095-C. You preview and approve Forms 1094-C and 1095-C on ADP Health Compliance pages before ADP files the forms electronically with the IRS. 20

23 Verifying Company Profile Data Overview In this topic, we will discuss the following: What Is the Company Profile? ACA Annual Reporting Impact Maintaining the Company Profile Tasks Updating the Company Profile 21

24 ACA Data Maintenance Checklist See ACA Data Maintenance Checklist, page 3. 22

25 What Is the Company Profile? Resources > Company Information > Company Profile Note: Because we are continually improving our solutions, the screens in this course may differ from those that you see in the product. 23

26 What Do You Think? Company Profile? True or false: The company profile is important because the data that you enter directly impacts the employer data on Forms 1094-C and 1095-C. a. True b. False 24

27 ACA Annual Reporting Impact For the most current IRS instructions and Forms 1095-C and 1094-C, refer to irs.gov. 25

28 Verifying that Company Profile Data Is Current Only FEINs associated with company codes ADP processes for payroll will be available in the top section. You need to enter non-adp company codes or FEINs by clicking Add External FEIN. This is required if you report as an Aggregated ALE Group. 26

29 Verifying that Company Profile Data Is Current (cont.) Geneva Entertainment FEIN: Geneva Games Company Code ABC Geneva Productions Company Code DEF 27

30 Aggregated Applicable Large Employer Groups Have you considered the following? Are you considering all of your employees? Are there other employees paid outside of ADP that are part of your organization? 28

31 What Is an Aggregated Applicable Large Employer Group? Organizations that qualify as an Aggregated Applicable Large Employer Group* are looked at as one single employer. If your organization meets certain IRS requirements of a controlled group, employees of all companies within the same aggregate group are combined to determine the ALE status for the entire aggregate group. *According to the IRS, certain affiliated employers that are part of a controlled group according to IRC Section 414(b), (c), (m), or (o) must aggregate (combine) their employees to determine whether they are an ALE. Form 1094-C refers to this group as an Aggregated ALE Group. 29

32 What Is a Controlled Group? A controlled group is a group of corporations that share ownership, like a parent-subsidiary relationship, a brother-sister relationship, or an affiliated service group if certain ownership thresholds are met. As mentioned on Form 1094-C, a controlled group of corporations is an Aggregated ALE Group. The rules regarding whether organizations with shared ownership rise to the level of a controlled group of corporations (or Aggregated ALE Group) are outlined in Internal Revenue Code Sections 414(b), (c), (m), and (o). It is critical that you consult with your legal counsel to determine whether you are part of a controlled group of corporations. 30

33 Example: Aggregated Applicable Large Employer Groups Adventure Tours, Inc. owns 100% of all its subsidiaries. Adventure Tours, Inc. (Parent) Adventure Tours Executive In-house manual payroll FTEs = 20 Adventure Tours West Company Code XYZ FTEs = 133 Adventure Tours East Company Code CBA FTEs = 112 Adventure Tours Total FTEs = 265 Combined, this organization is an ALE. Note: In this example, each of these entities must file separately if it has separate FEINs. Each then needs to list each other on Part IV of Form 1094-C in order of largest number of employees to smallest. 31

34 The ACA Aggregated ALE Group Tab 20XX 20XX 32

35 Important Note about the Company Profile ADP has taken steps to validate your FEIN information before sending it to ADP Health Compliance. From processing year 2016 onward, you are required to sync your payroll information to the company profile to ensure that the company profile contains the most current FEIN information. 33

36 Sync with ADP Payroll Where you initiate the sync process to add or update FEINs. Where you view the errors and warnings from the sync process for all of the company codes and FEIN assignments. You must click Submit to ensure that changes are sent to ADP Health Compliance. 34

37 Scenario After initiating the Sync with ADP Payroll process, you receive an error message indicating that your FEIN is missing contact information. You need to update the information so you can submit your company profile changes to ADP Health Compliance. 35

38 Note: You can switch to a collapsed menu by clicking here.

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51 You can download the entire error log here.

52 What Do You Think? Company Profile? You want to add the FEIN that is used to file your organization s Forms W-2. Which option would you click on the Company Profile page? a. Add External FEIN b. Sync with ADP Payroll 50

53 Topic Summary Correctly completing the Company Profile page is critical in processing your ACA annual reporting data. Use the Sync with ADP Payroll feature to verify that your FEIN information is correct, as it is used to file your organization s Forms W-2. This will reduce the chances of IRS rejections. You need to correct all errors before submitting information to ADP Health Compliance. 51

54 Completing ACA Compliance Attestations Overview In this topic, we will discuss the following: ACA Base Plan Attestation MEC and MV Attestations Conditional Offer to Spouse Attestation Certifying a Medical Plan for MEC and MV 52

55 ACA Data Maintenance Checklist See ACA Data Maintenance Checklist, page 1. 53

56 MEC and MV According to the ACA Definitions Minimum Essential Coverage (MEC) Group health insurance coverage offered by an employer to an employee that is available in the small or large group market, or a self-insured group health plan offered by or on behalf of an employer. Also includes Medicare, Medicaid, grandfathered health plans, and individual insurance policies. Minimum Value (MV) A plan provides minimum value if it is designed to pay, on average, at least 60% of participants covered medical expenses. Generally, you must use a minimum value calculator developed by the Department of Health and Human Services or obtain an actuarial certification to determine whether a plan provides minimum value. To access the minimum calculator for determining whether a plan provides minimum value, refer to irs.gov. 54

57 What Do You Think? MEC and MV? How do you know whether the type of coverage offered provides MEC and MV? a. All medical plans provide MEC and MV. b. Consult with your insurance broker or benefit plan administrator. c. Refer to the IRS website for guidance. d. B and C 55

58 Entering ACA Compliance Attestations Setup > Benefits > Plan Setup

59 Entering ACA Compliance Attestations (cont.) Setup > Benefits > Plan Setup Selecting Yes here causes Yes to be selected for the next two options. 57

60 Entering ACA Compliance Attestations (cont.) Setup > Benefits > Plan Setup Any plan not certified for MEC and MV will not be included in ACA reporting. Learning byte is available about this topic. 58

61 Entering ACA Compliance Attestations (cont.) Setup > Benefits > Plan Setup Select Yes only if the offer of coverage to an employee s spouse must meet one or more reasonable conditions. 59

62 ACA Annual Reporting Impact Scenario: This employer did not certify the medical plan for MEC and MV, resulting in code 1H populating on line

63 ACA Annual Reporting Impact (cont.) Scenario: This employer certified the medical plan for MEC and MV, and the offer to spouse is not conditional, resulting in code 1E populating on line 14. 1E 61

64 ACA Annual Reporting Impact (cont.) 1J Scenario: This employee was offered the following coverage for all days of the month which resulted in code 1J populating on line 14: Provided minimum essential coverage and minimum value to the employee Provided at least minimum essential coverage to the employee s spouse that was a conditional offer Didnot provide minimum essential coverage to the dependents of the employee 62

65 ACA Annual Reporting Impact (cont.) 1K Scenario: This employee was offered the following coverage for all days of the month which resulted in code 1K populating on line 14: Provided minimum essential coverage and minimum value to the employee Provided at least minimum essential coverage to the employee s spouse that was a conditional offer Did provide at least minimum essential coverage to the dependents of the employee 63

66 Important Information Before attesting that the coverage you offer meets MEC and MV requirements, consult with your legal counsel or the IRS website. 64

67 Verifying MEC and MV Attestations People > ACA > ACA Benefit Offerings

68 Scenario You notice that one of your ACA medical benefit plans, Geneva Medical, is not displayed on the ACA Benefit Offerings page. You need to explore whether Yes was selected for the MEC and MV attestations in the plan setup. 66

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77 Example: Calendar Year Plans Certify each plan spanning the reporting year. 75

78 Example: Noncalendar Year Plans Certify each plan spanning the reporting year. 76

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84 1/1/2017

85 Verifying MEC and MV Attestations People > ACA > ACA Benefit Offerings

86 What Do You Think? MEC and MV? You have the following medical plan years set up in ADP Workforce Now. Which medical plan do you need to certify for MEC and MV for 2017 annual reporting? a. July 1, 2015 July 1, 2016 b. July 1, 2016 July 1, 2017 c. July 1, 2017 July 1, 2018 d. B and C 84

87 Topic Summary During the administrative period or when you create or edit medical plans, you need to ensure that the ACA compliance attestations are accurate. The MEC, MV, and Conditional Offer to Spouse attestations affect the coding that is applied to Form 1095-C. 85

88 Setting Up and Reestablishing Measurement Periods Overview In this topic, we will discuss the following: What Are Look-Back Periods? ACA Annual Reporting Impact Explore: The ACA Measurement Periods Page Explore: The ACA Trending Dashboard Setting Up a New Standard Measurement Period 86

89 ACA Data Maintenance Checklist See ACA Data Maintenance Checklist, page 2. 87

90 What Do You Think? Measurement Periods? A measurement period is a standard period of time from months that is used to measure employees hours to determine whether they will be considered to be full-time employees. a. 1 2 b. 1 6 c. 2 3 d

91 What Do You Think? Administrative Periods? An administrative period is a period of time of up to that is optionally set up to occur between the measurement period and stability period. It is used to perform administrative functions. a. 30 days b. 60 days c. 90 days d. 120 days 89

92 What Do You Think? Stability Periods? A stability period is generally the same length as the measurement period but not shorter than months. a. 6 b. 7 c. 8 d. 9 90

93 What Are Look-Back Periods? Measurement Period Administrative Period Stability Period A standard period of time from 3 to 12 months that is used to measure employees hours to determine whether they will be considered to be fulltime employees. A period of time of up to 90 days that is optionally set up to occur between the measurement period and stability period. It is used to perform administrative functions such as enrolling eligible employees in health coverage. A period that is generally the same length as the measurement period, but not shorter than 6 months, during which an employee s status as full-time or parttime, which is based on the corresponding measurement period, is fixed. 91

94 Example In this example, an organization has a 12-month measurement period, 2-month administrative period, and 12-month stability period. Example Look-Back Period Setup Measurement Period Admin Period Stability Period 11/1/13-10/31/14 11/1/14-12/31/14 1/1/15-12/31/15 Year 1 11/1/14-10/31/15 11/1/15-12/31/15 1/1/16-12/31/16 Year 2 11/1/15-10/31/16 11/1/16-12/31/16 1/1/17-12/31/17 Year 3 92

95 ACA Annual Reporting Impact ADP Workforce Now uses measurement periods to assign the proper ACA benefit status to each applicable employee. For fully insured employers, an ACA benefit status of full-time enables a Form 1095-C to generate. 93

96 Explore: The ACA Measurement Periods Page Process > ACA > ACA Measurement Periods You can click View Employees to see a list of employees being measured in the initial measurement period. 94

97 Employee Categories Page Hourly Variable Hours 10/01/20XX 10/01/20XX 95

98 Initial Measurement Periods Page 06/01/ /31/ /15/ /01/ /31/ /15/

99 Standard Measurement Periods Page 12/01/20XX - 11/30/20XX (Active) Hourly Variable Hours Variable Hours 97

100 What Do You Think? Measurement Periods? Which tab do you need to review on a monthly basis to determine whether any administrative actions are required? a. Standard Measurement Periods b. Initial Measurement Periods c. Employee Categories 98

101 Explore: The ACA Trending Dashboard Process > ACA > ACA Trending Dashboard Click any number to view and download the associated list of employees. Click this button to export the data to Excel. 99

102 Scenario The ACA Trending Dashboard indicates that the number of full-time employees that were offered or not offered MEC dropped dramatically in December from 72 employees in November to 5 employees in December. It also indicates that many employees have an ACA benefit status of Not Defined in December. 100

103 Scenario (cont.) You check the information for one employee on the ACA Benefit Status page who should have been offered coverage in December You discover that the previous stability period ended on November 30 and the next stability period is missing. Therefore, you need to set up a standard measurement period that establishes a stability period beginning on December 1, People > ACA > ACA Benefit Status 12/1/ /30/2017 This screen may look different back in your office, but the functionality will be similar to what you see here. Your screen will be updated soon. 101

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106 This measurement period triggered a stability period of December 1, 2016, to November 30, 2017 (allowing for the administrative period). You need to add a measurement period of 12 months beginning September 2, 2016, so that your eligible employees have a stability period beginning December 1, 2017 (after the administrative period). 09/01/ /31/ /02/ /01/2016

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114 The new measurement period has been added. It will trigger a stability period beginning 12/01/17 (after the administrative period). 09/02/ /01/2017 (Historical) 09/01/ /02/ /31/ /01/2016 (Historical) 09/01/ /31/2016

115 What Do You Think? Setting Up Standard Measurement Periods If necessary, what do you need to create in ADP Workforce Now before setting up a standard measurement period? a. Employee categories b. ACA benefit status c. Stability period d. Administrative period? 113

116 Topic Summary You need to set up and reestablish measurement periods annually. Maintaining measurement periods ensures that employees are measured consistently. The ACA Trending Dashboard can help you identify any gaps in your measurement periods. 114

117 Updating ACA Benefit Status Overview In this topic, we will discuss the following: What Is an ACA Benefit Status? ACA Annual Reporting Impact Identifying Employees Who Are Eligible for Medical Benefits Assigning Your Employees an ACA Benefit Status 115

118 ACA Data Maintenance Checklist See ACA Data Maintenance Checklist, page

119 What Do You Think? ACA Benefit Status? True or false: An ACA benefit status identifies an individual employee s status (full-time, part-time, or not defined) and helps employers understand which employees are full-time under the ACA and need to be offered coverage in the employer s health plan based on the employee s hours of service. a. True b. False 117

120 ACA Annual Reporting Impact 09/1/20XX 08/31/20XX 118

121 Methods for Assigning Your Employees an ACA Benefit Status Designate an ACA benefit status during the onboarding process. Determine an ACA benefit status based on the hours calculation during the measurement period. Designate an ACA benefit status for existing employees. Designate the ACA benefit status of existing full-time employees whose status is missing via an import. Assign an ACA benefit status via a Mass Update. 119

122 Designating Employees ACA Benefit Status during the Onboarding Process Process > HR > Hire/Rehire 120

123 Methods for Assigning Your Employees an ACA Benefit Status Designate an ACA benefit status during the onboarding process. Determine an ACA benefit status based on the hours calculation during the measurement period. Designate an ACA benefit status for existing employees. Designate the ACA benefit status of existing full-time employees whose status is missing via an import. Assign Designate an ACA an ACA benefit benefit status status via a via mass a mass update. update. 121

124 Using Measurement Periods to Determine ACA Benefit Status 122

125 Methods for Assigning Your Employees an ACA Benefit Status Designate an ACA benefit status during the onboarding process. Determine an ACA benefit status based on the hours calculation during the measurement period. Designate an ACA benefit status for existing employees. Designate the ACA benefit status of existing full-time employees whose status is missing via an import. Assign an ACA benefit status via a mass update. 123

126 Designating Existing Employees ACA Benefit Status People > ACA > ACA Benefit Status 09/1/20XX 08/31/20XX 124

127 Designating Existing Employees ACA Benefit Status (cont.) People > ACA > ACA Benefit Status Part-Time 09/1/20XX 08/31/20XX 09/1/20XX 08/31/ 9/30/20XX Part-Time 125

128 Designating Existing Employees ACA Benefit Status (cont.) People > ACA > ACA Benefit Status 09/30/20XX. 9/30/20XX 126

129 Designating Existing Employees ACA Benefit Status (cont.) People > ACA > ACA Benefit Status 9/30/20XX 9/30/20XX 127

130 Methods for Assigning Your Employees an ACA Benefit Status Designate an ACA benefit status during the onboarding process. Determine an ACA benefit status based on the hours calculation during the measurement period. Designate an ACA benefit status for existing employees. Designate the ACA benefit status of existing full-time employees whose status is missing via an import. Assign an ACA benefit status via a mass update. 128

131 Importing Employees ACA Benefit Status Process > Utilities > Import Import template 1/1/20XX 1/1/20XX 1/1/20XX 1/1/20XX 1/1/20XX 1/1/20XX 1/1/20XX 1/1/20XX 1/1/20XX 129

132 Methods for Assigning Your Employees an ACA Benefit Status Designate an ACA benefit status during the onboarding process. Determine an ACA benefit status based on the hours calculation during the measurement period. Designate an ACA benefit status for existing employees. Designate the ACA benefit status of existing full-time employees whose status is missing via an import. Assign an ACA benefit status via a mass update. 130

133 Benefit Status Mass Update Process > ACA > ACA Measurement Periods 131

134 Benefit Status Mass Update (cont.) 07/01/ /30/2017 for ALL 09/01/ /31/ /01/ /31/ /01/ /31/ /01/ /31/ /01/ /31/ /01/ /31/ /01/ /31/ /01/ /31/ /01/ /31/ /01/ /31/ /01/ /31/ /01/ /31/ /01/ /31/ /01/ /31/ /01/ /31/ /01/ /31/ /01/ /31/ /01/ /31/ /01/ /31/ /01/ /31/

135 Benefit Status Mass Update (cont.) 06/02/ /01/2017 for ALL 09/01/ /31/ /01/ /31/ /01/ /31/ /01/ /31/ /01/ /31/ /01/ /31/ /01/ /31/ /01/ /31/ /01/ /31/ /01/ /31/

136 Methods for Assigning Your Employees an ACA Benefit Status Designate an ACA benefit status during the onboarding process. Determine an ACA benefit status based on the hours calculation during the measurement period. Designate an ACA benefit status for existing employees. Designate the ACA benefit status of existing full-time employees whose status is missing via an import. Assign an ACA benefit status via a mass update. 134

137 Important Note An employee s ACA benefit status does not determine an employee s eligibility for a benefit plan. Plan eligibility is set up separately in ADP Workforce Now Benefits. If an employee deemed to have a full-time ACA benefit status at the end of the measurement period is unable to enroll in medical benefits, you may have to update the employee's benefits eligibility class. Learning byte available about this topic. 135

138 ? What Do You Think? Methods for Assigning Employees an ACA Benefit Status During the onboarding process, you selected the measurement period method to calculate a new hire s ACA benefit status. The employee currently has a part-time ACA benefit status but should be full-time. Can you update this employee s ACA benefit status? a. Yes, you can manually designate a full-time ACA benefit status. b. No, you cannot change an ACA benefit status after it has been assigned. 136

139 Identifying Employees with a Not Defined ACA Benefit Status Process > ACA > ACA Measurement Periods 137

140 Employees with a Not Defined ACA Benefit Status Common Reasons Hire date is missing. Hours of service could not be determined. No hours of service are available for the measurement period. Payroll is not processed for the entire measurement period. 138

141 Employees with a Not Defined ACA Benefit Status (cont.) 09/01/20XX 08/31/20XX 10/15/20XX 10/16/20XX 10/15/20XX 139

142 Scenario While reviewing the ACA Trending Dashboard, you notice that one employee, Roberta Carney, is not defined. You recognize Roberta as a full-time employee. You need to access the ACA Benefit Status page in order to designate her ACA benefit status as full-time. 140

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149 09/1/ /31/2017 You use the first option if you want to manually designate a full-time status for the current stability period only and go back to using calculations in the future. 09/01/20XX 08/31/20XX

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153 What Do You Think? ACA Benefit Status? You manually designated a new employee with an ACA benefit status of full-time. How long will this status remain in effect? a. Until the next measurement period b. Until you manually update his or her status c. Until the employee completes 90 days of service 151

154 Topic Summary You need to review ACA benefit status designations during the administrative period and at year end. An ACA benefit status of full-time enables a Form 1095-C to generate (if fully insured). A status of Not Defined, Not Available, or Part-Time (if fully insured) will not generate a Form 1095-C. 152

155 Auditing ACA Data on ADP Health Compliance Pages Overview In this topic, we will discuss the following: ACA Benefit Offerings Page Comparing the ACA Benefit Offerings Page with ADP Health Compliance Pages ACA Benefit Offerings Summary Page Reviewing Forms 1095-C in ADP Health Compliance 153

156 ACA Data Maintenance Checklist See ACA Data Maintenance Checklist, page

157 What Do You Think?? Employee data that is displayed on Forms 1095-C is taken directly from which page in ADP Workforce Now? a. ACA Benefit Offerings b. ACA Benefit Status c. Company Profile d. Affordable Care Settings 155

158 Explore: ACA Benefit Offerings Page People > ACA > ACA Benefit Offerings 9.56 $

159 Explore: ACA Benefit Offerings Page (cont.) 05/25/20XX 12/31/20XX 157

160 Comparing the ACA Benefit Offerings Page with ADP Health Compliance Pages: Fully Insured If the ACA Benefit Offerings Page Displays An ACA benefit status of full-time Offered medical coverage identified as MEC A check mark in the Affordable column under Offered Medical Coverage An affordability calculation method Minimum essential coverage providing minimum value is offered to employee, minimum essential coverage is not offered to dependents, and at least minimum essential coverage is conditionally offered to spouse Minimum essential coverage providing minimum value is offered to employee, at least minimum essential coverage is offered to dependents, and at least minimum essential coverage is conditionally offered to spouse Then Form 1095-C will generate. The applicable code is displayed on line 14 of Form 1095-C. (For example, 1B, 1C, 1D, 1E, 1F.) The employee cost is displayed on line 15 of Form 1095-C. This is the dollar amount of the lowest-cost monthly premium offered for self-only not necessarily what the employee elected. The applicable safe harbor or situational code is displayed on line 16 of Form 1095-C. (For example, 2A, 2B, 2C, 2D, 2E. Note that 2C trumps any other applicable codes. The affordability safe harbor codes are 2G, 2H, and 2F if the employee does not enroll in coverage.) Form 1095-C will display code 1J on line 14. Form 1095-C will display code 1K on line

161 Comparing the ACA Benefit Offerings Page with ADP Health Compliance Pages: Self-Funded If the ACA Benefit Offerings Page Displays An individual enrolled in self-funded MEC Offered medical coverage identified as MEC (when the ACA benefit status is full-time) A check mark in the Affordable column under Offered Medical Coverage (when the ACA benefit status is full-time) An affordability calculation method (when the ACA benefit status is full-time) An ACA benefit status that is not full-time, but the individual is enrolled in self-funded MEC Dependents enrolled in self-funded MEC Minimum essential coverage providing minimum value is offered to employee, minimum essential coverage is not offered to dependents, and at least minimum essential coverage is conditionally offered to spouse Minimum essential coverage providing minimum value is offered to employee, at least minimum essential coverage is offered to dependents, and at least minimum essential coverage is conditionally offered to spouse Then Form 1095-C will generate. The applicable code is displayed on line 14 of Form 1095-C. (For example, 1B, 1C, 1D, 1E, 1F.) The employee cost is displayed on line 15 of Form 1095-C. This is the dollar amount of the lowest-cost monthly premium offered for self-only not necessarily what the employee elected. The applicable safe harbor or situational code is displayed on line 16 of Form 1095-C. (For example, 2A, 2B, 2C, 2D, 2E. Note that 2C trumps any other applicable codes. The affordability safe harbor codes are 2G, 2H, and 2F if the employee does not enroll in coverage.) Code 1G will be displayed on line 14, and lines 15 and 16 will be blank. Dependent information and months enrolled is displayed in Part III of Form 1095-C. Form 1095-C will display code 1J on line 14. Form 1095-C will display code 1K on line

162 Reviewing ACA Benefit Status: Fully Insured If the ACA Benefit Offerings page displays an ACA benefit status of full-time, Form 1095-C will generate in ADP Health Compliance. 0 $

163 Reviewing Elected Medical Coverage: Self-Funded If the ACA Benefit Offerings page displays an individual enrolled in self-funded MEC, Form 1095-C will generate in ADP Health Compliance /05/20XX 12/31/20XX 161

164 Reviewing Offered Medical Coverage If offered medical coverage is identified as MEC, the applicable code is displayed on line 14 of Form 1095-C. Scenario: The employee enrolled in the MEC/MV offered, which included dependents and spouse

165 Reviewing the Lowest-Cost Plan Offered The Affordable column indicator is designated for the plan in which the employee offering is the lowest-cost employee-only plan meeting MEC and MV or the employee offering is the designated ACA base plan

166 Reviewing Affordability Calculation Method If an affordability calculation method is displayed, the applicable safe harbor or situational code is displayed on line 16 of Form 1095-C. Scenario: This employee enrolled in the coverage offered, so the code is 2C

167 Reviewing ACA Benefit Status (Self-Funded Only) If the ACA Benefit Offerings page displays an ACA benefit status that is not full-time but an individual is enrolled in self-funded MEC, code 1G will be displayed on line 14, and lines 15 and 16 will be blank. 06/30/20XX 06/29/20XX /05/20XX 12/31/20XX 165

168 Reviewing Dependents (Self-Funded Only) If the ACA Benefit Offerings page displays dependents, dependent information and months enrolled is displayed in Part III of Form 1095-C

169 Explore: ACA Benefit Offerings Summary Page You can expand all the categories at once by clicking Expand All. 20XX 20XX 20XX 20XX 20XX 20XX 167

170 Reviewing the Employment Section 20XX 20XX 20XX 20XX 20XX 20XX 168

171 Reviewing the Benefit Offering Section 20XX 20XX 20XX 20XX 20XX 20XX 169

172 Reviewing the Enrollment Section 20XX 20XX 20XX 20XX 20XX 20XX 170

173 Reviewing the Details of the ACA Benefit Offerings Summary Page 20XX 20XX 20XX 20XX 20XX 20XX 171

174 Scenario Kate Brewster is employed full time by your company, JC Design Company. Kate left JC Design Company on June 2 to start a new job. The benefit plan coverage extends through the end of June. You need to check the monthly ACA benefit offerings to be sure that the data is accurate for your year-end ACA reporting. 172

175 Reviewing Month-by-Month Details for Employment 20XX 20XX 20XX 20XX 20XX 20XX 173

176 Reviewing Month-by-Month Details for Employment (cont.) 174

177 Reviewing Month-by-Month Details for Employment (cont.) 175

178 Reviewing Month-by-Month Details for Employment (cont.) 176

179 Reviewing Month-by-Month Details for Employment (cont.) 177

180 Reviewing Month-by-Month Details for Employment (cont.) 178

181 Reviewing Month-by-Month Details for Benefit Offering 179

182 Reviewing Month-by-Month Details for Benefit Offering (cont.) 180

183 What Do You Think?? What if JC Design Company ends the benefit offering on the day of Kate s termination, June 2? Would you see a red X or a check mark for June?? 181

184 What Do You Think? (cont.)? You would see a red X for June because the employer failed to offer coverage to the full-time employee for the entire month. 182

185 Reviewing Month-by-Month Details for Benefit Offering (cont.) 183

186 Reviewing Month-by-Month Details for Enrollment Brady Brewster 184

187 Reviewing Month-by-Month Details for Enrollment (cont.) Brady Brewster 185

188 Scenario Samuel Barbato is enrolled in self-funded coverage from March 1 to December 31. Samuel enrolled his child in coverage effective June

189 Scenario (cont.) 20XX 20XX 20XX 20XX 20XX 20XX 187

190 What Do You Think?? If Samuel enrolled his child in coverage effective June 25, should a red X or a check mark be displayed for June?? 188

191 What Do You Think? (cont.)? You would see a red X for June because the child was not enrolled in coverage for the entire month of June. 189

192 Reviewing Forms 1095-C in ADP Health Compliance Process > ACA > ACA Health Compliance Learning byte available about this topic. 190

193 Reviewing Forms 1095-C in ADP Health Compliance (cont.) 191

194 What Reports Are Available to Assist You? Reports > Standard Reports > ACA > ACA Benefit Offering Audit /20XX /20XX 06/30/20XX 06/29/20XX 192

195 What Reports Are Available to Assist You? (cont.) Process > ACA > ACA Health Compliance > Health Care Reports > ACA 1095C Transmission Status Detail 193

196 Topic Summary Employee data that is displayed on Forms 1095-C is taken directly from the ACA Benefit Offerings page. The ADP Health Compliance pages, the ACA Benefit Offerings page, and the ACA Benefit Offerings Summary page provide information to help you audit your Forms 1095-C. 194

197 Resources and Next Steps Overview In this topic, we will discuss the following: ACA Annual Reporting Milestones Managing ACA Annual Reporting Data Additional Resources Post-Webinar Hands-On Practice 195

198 ACA Annual Reporting Milestones 196

199 Managing ACA Annual Reporting Data 197

200 What Other Resources Are Available? 198

201 Access The Bridge TheBridge.adp.com 199

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204 Additional Resources Resource Location ACA Benefits Administration for ADP Workforce Now Benefits Overview for ADP Workforce Now Getting Started with Benefit Plan Setup for ADP Workforce Now Setting Up Health and Welfare Plans in ADP Workforce Now Maintaining Benefit Plans in ADP Workforce Now Learning bytes Support > Health Care Reform > Learning > ACA Learning Bytes Online Help Click (help) on any page. 202

205 Essential ACA Learning Bytes 203

206 Post-Webinar Hands-On Practice Log on to and complete this short practice: Maintaining Annual Reporting Information for ADP Workforce Now Essential ACA Current Version: Practice 204

207 Course Closing: Fully Insured Only Now that you have completed this webinar, you are prepared to do the following: Describe how your data flows to ADP Health Compliance. Perform tasks in ADP Workforce Now to ensure that your ACA information remains accurate and current. Conduct a monthly audit of annual reporting forms in ADP Health Compliance. 205

208 Training Evaluation Click the Survey icon at the bottom of your screen to access the evaluation. 206

209 Thank You! If you are fully insured, thank you for attending! You can exit the course now. If you offer self-funded medical plans, stay with us as we address a final topic just for you. 207

210 Maintaining Self-Funded Plans Overview In this topic, we will discuss the following: ACA Annual Reporting Impact of Self-Funded Plans Self-Funded Plan Tasks Updating COBRA Enrollees and Retirees 208

211 ACA Data Maintenance Checklist See ACA Data Maintenance Checklist, page

212 Form 1095-C: Self-Funded Plans 210

213 Form 1095-C, Part III: Covered Individuals 211

214 What Do You Think? Employers That Offer Self-Funded Plans? True or false: Employers that offer self-funded plans need to provide Form 1095-C to nonemployees, such as retirees and COBRA recipients. a. True b. False 212

215 Completing Form 1095-C, Part III: Covered Individuals Applicable large employers (ALEs) that sponsor self-funded group health plans must complete Part III of Form 1095-C for any employee or nonemployee, in addition to completing Parts I and II. Nonemployees can include the following: Employees dependents Retirees COBRA participants 213

216 What Do You Think? Self-Funded Plans? True or false: Individuals covered under a self-funded plan must receive a Form 1095-C regardless of their ACA benefit status. a. True b. False 214

217 ACA Benefit Status Is Required with Self-Funded Plans All individuals covered under a self-funded plan will receive a Form 1095-C, but they also require an ACA benefit status. For example, a part-time ACA benefit status could impact the code that appears on Form 1095-C, line

218 Populating Form 1095-C, Part III Part III of Form 1095-C is populated under these circumstances: The benefit plan is self-funded. The employee is enrolled in the self-funded plan. The employee has dependents who are enrolled in coverage. The benefit plan is certified for MEC. 216

219 ACA Data Maintenance Checklist See ACA Data Maintenance Checklist, page

220 Designating a Medical Plan as Self-Funded Setup > Benefits > Plan Setup 1/1/20XX All self-funded plans must have Yes selected in the Treat This Plan as Self-Funded for ACA Reporting field. 218

221 ACA Data Maintenance Checklist See ACA Data Maintenance Checklist, page

222 Verifying Dependent Data People > Benefits > Dependents & Beneficiaries All dependent data must be up to date for active and terminated employees. 220

223 ACA Data Maintenance Checklist See ACA Data Maintenance Checklist, page

224 Reviewing Terminated Employees People > Benefits > Enrollments 09/10/20XX Ensure enrollments are entered for terminated employees. 222

225 Reviewing COBRA Enrollees and Retirees People > Employment > Employment Profile COBRA Enrollee Retirees Set worker category to COBRA. The employment status must be set to Retired. 223

226 ACA Data Maintenance Checklist See ACA Data Maintenance Checklist, page

227 ? What Do You Think? Designating a Medical Plans as Self-Funded For which option would you select Yes to ensure that Part III of Form 1095-C is populated? a. Is This Plan Self-Funded? b. Treat This Plan as Self-Funded for ACA Reporting? c. A and B 225

228 Topic Summary Employers that offer self-funded plans must complete Part III of Form 1095-C. All covered dependents and their Social Security numbers are displayed there. Employers that offer self-funded plans must provide Forms 1095-C to nonemployees, such as retirees and COBRA recipients. See the IRS website for more information. Individuals covered under a self-funded plan will receive a Form 1095-C regardless of their ACA benefit status. If your organization offers self-funded plans, see the Self-Funded Plans Only section of the ACA Data Maintenance Checklist to determine the tasks that you need to complete during the administrative period or when setting up or editing medical plans. 226

229 Course Closing Now that you have completed this webinar, you are prepared to do the following: Describe how your data flows to ADP Health Compliance. Perform tasks in ADP Workforce Now to ensure that your ACA information remains accurate and current. Conduct a monthly audit of annual reporting forms in ADP Health Compliance. Complete tasks specific to self-funded medical plans. 227

230 Training Evaluation Click the Survey icon at the bottom of your screen to access the evaluation. 228

231 Thank You! It was my pleasure to work with you today! 229