EMPEON 2020 ACA PROCESS

In order to process 1094-C and 1095-C forms, users can now access the ACA and Insurance Setup Fields in Company > Benefits. 

Step 1: ACA

In Company > Benefits > Company ACA, add the ACA rules for your company. Click the Add ACA button and set the effective dates to January 1 through December 31 of the year of processing.

Choose an option to indicate who should be measured. If we are not measuring ALL, you will need to update the ACA Status card in the Employee profiles to indicate who is Full Time and for what dates. This can be done manually or by using a Power Import. (Actions > Power Tools > Employment Status)

Select a Measurement Method to measure your employees’ ACA Hours. (See the ACA Measurement Methods Demystified which explains each method.)

Note: The Monthly Measurement will create a 1095-C for any employee that worked full time hours for even one month during the year. The codes will fluctuate monthly according to actual hours worked that month. As such, it is recommended that you utilize the Lookback Measurement Method which complies with all ACA laws and regulations.

For the Lookback Measurement Method, complete the fields to indicate your company’s measurement periods. Keep in mind that measurement periods and stability periods should begin on the date of your annual insurance renewal.

Regardless of Measurement Method chosen, Code Groups must be maintained for the measurement to calculate based on ACA Hours only. Once you choose a method, follow the ACA Code Group link that appears and add/update a Code Group named ACA. Mark the Earnings Check box and select all earning codes that should be included in the ACA measurement calculations. Per the IRS, “An hour of service is each hour for which an employee is paid, or entitled to payment, for the performance of duties or entitled to payment by the employer for a period of time during which no duties are performed due to vacation, holiday, illness, incapacity (including disability), layoff, jury duty, military duty or leave of absence.”

Step 2: Insurance Plans

Insurance plans offered must be entered in Company > Benefits > Company Insurance.

Set up each plan offered, naming the plan using up to 10 digits and no dashes.

Use Renewal Dates as effective dates for each plan. Select all checkboxes that apply. Whenever changes are made to the insurance plans offered, you will need to create a new plan, (you can use the same plan name with different effective dates).

If a plan is Self Insured, dependent information will be required.

Use the Premium Setup fields to indicate premium cost as well as Single Level Employer Contributions. (The system will derive the employee cost) For flat amount Employer Contributions, enter 100% up to the contribution amount.  

The Eligibility section tracks which employees are eligible for this specific plan. Choose “Specific Employees” and indicate which fields drive the eligibility. The system will assume that all eligible were offered coverage when eligible. If you choose to track offers of coverage by adding the Insurance plan to each employee with the date of offer, note that in your ACA ticket.

Step 3: Enrollment

Enrollment can be entered manually per employee or by Power Import. 

Manually: On an employee level, Benefits > Insurance, all enrollees must be set up with the Insurance plan they were on. Select Elected vs. Offered and enter the effective date of their enrollment. Choose the coverage level or ‘based on dependents’ if applicable. For Self Insured plans, dependents must be selected and require either a SSN or DOB in the Dependent card.

Override Premiums and Employer Contributions that differ from the default (e.g., Employee’s entire plan cost was covered by Employer).

Import: Utilize the Insurance Power Imports to batch import employee enrollment: Each line will require and Employee ID. iCode is the name of the insurance plan. Make sure to input Start Dates and End Dates (year end if none) and Offer outcome: Elected to assign enrollment to an employee. Use Column “ovDepPlan” to indicate level of coverage: Employee, Spouse, Child, Children, Family. If left blank it will go based on dependents added to the plan. All other columns are optional and can be used to override premiums and employer contributions that differ from the default (e.g., Employee’s entire plan cost was covered by Employer).

For self insured plans, utilize the Dependents Power Import to add the dependents to the employee profile Dependents card. In addition, if you have a self-insured plan, you must email a spreadsheet of all enrollees so Empeon can link the dependents to the appropriate plans.

Once you have entered all appropriate information, or for assistance during the process, reply to your existing ACA ticket and we will work with you to complete the process.