ACA Solutions

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The Patient Protection and Affordable Care Act, also known as the ACA for short, was signed into law March 23, 2010. This was a large list of new rules and regulations governing the medical insurance industry, employers, and individuals in the U.S. The majority of ACA provisions went into effect on January 1st, 2014. 

The ACA had a sweeping effect on how health insurance plans were administered and added a slew of new compliance issues for many businesses throughout the U.S. Regardless of your company size, the ACA has affected what you need to be doing to stay in compliance. 

There are additional rules and regulations for all Applicable Large Employer (ALE). You may notice that the ACA mentions "Applicable" large employers, and not simply "Large Emlpoyers". This is because there is a number of factors used in determining your applicable large employer status. 

Those factors include, the number of full-time employees, number of part-time employees, number of total hours for the part-time employees, seasonal employees, and more. 

To keep things simple, if have 50 or more full-time employees on average during the prior year, you are an Applicable Large Employer. 

If you have less than 50 full-time employees, you may still qualify as an Applicable Large Employer. Depending on the number of part-time employees and the hours they work, the ACA calculates their 'full-time equivalent' value. 

Controlled Groups and Applicable Large Employers

The ACA also considers an owner or owner group with multiple companies as one single entity when calculating whether or not your are an ALE. For example, if you owned a pizza restaurant with 25 full-time employees and an entirely separate sushi restaurant with 30 full-time employees, both entities would be considered an Applicable Large Employer. 

We can help determine whether or not you are a full-time employer. 

One of the major provisions of the ACA was the "Pay or Play" provision for employers with 50 or more full-time and full-time equivalent employees. 

As an Applicable Large Employer you must offer your employees affordable health insurance that meets the guidelines for minimum essential value. 

If you choose not to offer your employees affordable health insurance which meets the guidelines for minimum essential value, you could pay a large penalty. 

• Penalty A: Not offering any coverage to at least 95% of your full-time employees would result in a penalty of $2,500 per full-time employee in 2019, minus the first 30. This penalty amount will increase each year. The original penalty was $2,000 in 2014. 
• Penalty B: Not offering coverage that meets minimum essential value and/or not offering coverage which meets the affordability guidelines would result in a penalty of $3,750 per employee who receives individual premium assistance. 

Please contact us immediately if you have received a penalty notice from the IRS or if you feel you could receive a penalty in the future. 

The ACA requires all applicable large employers to file new forms indicating whether or not you offered your employees health insurance, if it was affordable, and when they qualified, for each month of the year. 

These are the new 1095-C forms which must be filed with the IRS every year and mailed to each current and former employee, similar to the rules of a W2. Our office has been fully administering and filing these forms with IRS since the beginning. 

Don't tackle this on your own and certainly don't let an inexperienced firm manage it for you. The last think you want is a notice from the IRS with a large penalty because the forms weren't properly filled out. 

If you have received a Letter 226J from the IRS with an Employer Shared Responsibility Payment, please contact us immediately. Our team can exam your situation to ensure you pay only the you amount should after any corrections are made.