The ACA Self-Insured toggle is no longer used. That determination is made on individual plans.
If the medical plan type is identified as a self-insured plan type, then all benefit plans that are associated with the medical plan type must have the ACA Self Insured toggle set on in order to include all dependent sons and daughters in the ACA reporting.
On the Coverage Details tab, further information about the affordability and level of the coverage, for ACA purposes is required.
Only the basic self-only coverage should be identified as the minimum value coverage. If more than one coverage is selected, the ACA process will only use the coverage with the lowest cost premium. If there are multiple medical plans offered to employees, only one should be selected.
ACA Min. Value Self | As the system has no way to determine if the plan meets Minimum Essential Coverage, as defined by the IRS Rules, you would only toggle on a self-only coverage if it meets that criterion. |
ACA Monthly EE Prem | This is the cost to the employee for this coverage. It may be the employee deduction rate from the Rates tab, or another value. Note that this value must represent a monthly rate. |
ACA Coverage | This is used for ACA reporting on the 1095C form. The options listed are for the type of coverage selected. The value will be shown as a code in Line 14 on the 1095C form and in VBACAE. (See list of Line 14 codes on page 23). |
ACA UserCalc | This option allows for a UserCalc to compute the ACA Monthly Employee Premium, rather than take it from the field above. This allows you to perform pro-rating or other computations as may be needed. The value from the UserCalc will be displayed in VBACAE and in the UBACA spreadsheet. The UserCalc Product is BE and is of a type Function. It will return a number value which will be used by UBACA as the ACA Monthly EE Premium rate (this will override any rate entered into the ACA Monthly EE Prem in IBPN). Currently UserCalcs executed from within UBACA have access to these tables: *IBPT screen: BPT *IBPN screen: BPN BCG BCGD BCGC BCGR *IBEN screen: BEN BEND *IEID screen: EID *IEEI screen: EEM *IEAS screen: EAS EASD *IEST screen: EST *IDUN screen: DUN (not details) *IDGR screen: DGR (not details) |
The rule is that coverage must be offered to all full time employees although they do not have to actually be enrolled in that minimum coverage, or any coverage. In Personality, being offered a plan/coverage requires that it shows (from the schedule) in the list of benefit plans available for enrollment.
The regulations permit an employer to use measurement periods and stability periods that differ either in length or in their starting and ending dates for different categories of employees specified in the regulations, provided that the employees within each category are treated consistently. The categories specified in the proposed regulations are:
ACA Category | Mandatory code that you will use to identify your ACA Category |
Description | Optional, description of the ACA Category |
Entity | Optional – only needed if you have multiple entities and different rules for them. |
State, Country | Optional – only needed if you are employing in multiple states and have different rules for them. |
Unit | Optional – only needed if you have different rules by unit and wish to identify them in this manner (not required) |
ACA Hours Rule | Look-Back … If you choose Look-Back, you must fill in the fields below in the lookback section Monthly Measurement … This option will compute the hours an employee works by only looking at the month entered in the UBACA form. Weekly Measurement … This option will determine the hours worked by week within a month. The number of weeks in the measurement month may be 4 or 5, depending on the month selected in UBACA. Four weeks will use 120 hours for the minimum hours and five weeks will use 150, for determination of full time status. |
Start Day of Week | Options are to select a specific day as the start of the week (for use only with the Weekly Measurement method). |
Hours Element | The element selected here will contain all of the pay components that represent paid time taken. |
ACA Wage Rule | Federal Poverty Level … This method uses the monthly federal poverty level entered into a user variable (IMVR) named FPL Rate of Pay … This method will determine the wage rate, as specified in the ACA Payroll field, below. Form W2 Wages … This method uses the month-to-date values from IPVT for the month selected in UBACA, for the element identified as the wages element. |
Wages Element | This element should represent W2 wages as reported in Box-1 in form W-2. This represents federal taxable earnings and federal supplemental taxable wages. |
ACA Payroll | Hourly … The monthly wage is determined as follows, as per IRS rule: 130 X the lowest hourly Pay Line (IPPH) wage rate during the calendar month identified in UBACA. Salary … The monthly wage is determined by looking at the IEAS wage rate on the first day of the month identified in UBACA. |
Lookback Months | Must contain a number of months from 3 to 12. |
Measure Period Start | Optional field. This date will define the day in a month that the measurement period will start |
Admin Period | Optional field. May not be more than 90 days. |
Stability Period | Optional field. Defines the length of the stability period and must be between 6 and 12 months. |
Service Break Rule | This is for future development. |
Leave Element | This is for future development. |
ACA Category | Optional field. You may enter an ACA Category (IBACA) here which will be an override to the one inherited from the employee’s group. |
ACA Excluded | Optional field. You may enter a value here to override the line 14 value for this employee No offer … This will result in a Line 14 code of 1H and no calculations will be performed. Transition … This will result in a Line 14 code of 1I and no calculations will be performed. |
If the ACA Wage Rule in IBACA has the Rate of Pay selected, and the ACA Payroll is Salary, then there must be hours per week/day available for the calculation of a monthly wage to take place. Hours per Day and Week must be entered into at least one of the following screens.
If a dependent is covered by an enrolled health plan, this will be shown on the Benefit Recipients data. You can see this data through IBRP (by Plan) or through IBRA (by dependent) screens. These two screens present the same data, just viewed differently.
Note that the percentage must be filled in for UBACA to pick up these records and note that the dependent is covered.
A system-provided template definition is available in IDIF called HL$ACA-1094C.
It is recommended that you copy this template definition and a create copy (or copies) of your own, so that it is not overwritten in subsequent patch updates.
This IDIF definition contains 41 values that may need to be modified to values that are for your own organization. These values are used in the production of the 1095C form that is destined for the employee, and the 1094C form and file that must be submitted to the IRS.
The record number/field number are inconsequential in this definition. What is important is the name of the field that the system is looking for and the constant value you provide. Wiki : AFFORDABLE CARE ACT - Plugin insertion failed: Could not find plugin TableWiki : AFFORDABLE CARE ACT - Plugin insertion failed: Could not find plugin Table
If IBACA has ACA categories that are using the ACA Hours Rule Look-Back, then the time accumulated from the months that have been defined as the Look Back period will be used to create the average hours for the hours worked for the month specified.
UBACA will only process employees whose assignment employment status is associated to the Status Types Active, Pending, Leave or Unpaid Leave.
If the option Generate for 1095C is set to YES, then all employees in the selected Entity will be included in the report, filters are ignored, and the results are saved to the database for reporting at year-end. If you have previously processed a month with this flag set to YES, then subsequent runs with the flag to NO will just report the data (again) and will not re-compute the data. The only intent of this toggle is to provide a performance aid in the scenario where you need to run the UBACA report for multiple groups of people, but want to only show subsets of employees. Once there is a record for any employee with the “Final” toggle turned on, UBACA does not go through the data for that month, but rather simply reports on the data that is in the database. You do not need to run UBACA with this toggle on in order to produce 1095C/1094C output. |
This report will generate a Microsoft Excel spreadsheet. If the option ‘Print Cover Page’ = Yes, then exception messages can be viewed in the spread sheet. Exception messages are always viewable in DMEX/VMEXF/VMEX/RMEX.
Report Parameters & Filters
Report Parameters | |
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Entity | You must enter one entity. UBACA only runs for one Entity at a time.(Mandatory) |
Year | Enter the year that you want to report on |
Month | Enter the month that you want to report on |
Use Eligibilty Date | Default (empty) is No. If you set this to Yes, then the eligibility start/end dates will be used to determine when an employee is covered by a plan, rather than the effective and expiry dates. This may suit your set up better, but not that there is no constraint or guarantee that eligibility dates are contiguous, without gaps or without overlap. If you select this parameter, then only those records with the eligibility dates filled in will be reviewed. |
Generate for 1095C | No/Yes. If set to YES, all report filters are ignored and all employees will be processed by UBACA. If set to NO, then report filters can be used to select subsets of employees. If you have previously processed a month with YES, then running with NO will simply report on the data previously saved. You can always replace the saved data by running again with YES. See the detail above on the intent of this toggle. Recommendation: Leave it as NO unless you have a requirement to provide UBACA reports for different subsets of employees |
Print Cover Page | This parameter has been removed. It’s original intent was to suppress the cover page from the report, but since it has been moved to a different tab, there is no need to do this anymore. |
Report Filters |
There are three tabs at the bottom of the spreadsheet:
The PARAMETERS tab will show the report parameters that were selected in UBACA
The RUN LOG tab will show the execution trace and other diagnostic message
The REPORT tab will show the data in the report in the same manner as this example
Some key fields are:
Full Time | The determination as to whether the employee is full time or part time is made based on the Hours worked in the Hours field. If the hours are less than 130, then for the purpose of the ACA report, the employee is Part Time, e.g. there will be a No in this field. |
Hours | If the IBACA ACA Hours Rule is Monthly measurement then these are the hours worked in the month being executed. If the rule is Look-Back, then this number will represent the average hours worked during the look-back period defined in the Lookback Months field. |
Wage Rate | This derived from a source based on the ACA Wage Rule. |
Enrolled Plan/Covg | This is the medical benefit plan and coverage the employee is actually enrolled in |
Line 14 Code | This is the line 14 code relating to the employee this month (see the list on page 23) |
Line 16 Code | This is the line 16 code relating to the employee this month (see the list on page 24) |
Covered Plan/Covg | This is derived from the ACA Monthly EE Prem field in the ACA coverage. |
Coverage Rate | This is derived from the ACA Monthly EE Prem field in the ACA coverage. |
Affordability | The Yes/No option in this column is selected by the result of a calculation done by UBACA. If 9.5% of the Wage Rate is less than the Cost, then the plan is not affordable and a No is entered in this field. |
The Year and Month are derived from the Year (YYYY) and Month (MM) fields in UBACA.
The ACA Category is read from the employee’s Group screen or assignment if an override has been entered there.
Enrolled in Plan/Coverage will show the current enrollment of the employee in the medical plan and coverage (if any).
Line 14 box may contain one of the following codes, and will be printed in the 1095C accordingly:
The ACA Period is populated by UBACA only when a look-back measurement period is selected for the employee. The options are:
Covered by Plan/Coverage will display the ACA Minimum Value Self benefit plan and coverage.
Coverage Rate is the coverage premium rate from IBPN.
Wage Rate is derived from the source indicated in IBACA.
Hours will hold the average hours for the month or for the lookback period.
FT will be toggled on if UBACA determines that the employee is Full Time, e.g. has worked an average of more than 130 hours per month.
The lower section of this screen will show any dependents if the plan is designated as ACA Self Insured in IBPN and there are dependents entered in IECT as Dependents in the Contact Type field and the dependents are associated with the Medical plan in IBRA at a coverage rate greater than 0 (or null).
Note: When UBACA is run for with the 1095C option as Yes, it can be run again for the same month/year with the 1095C option as No. This will generate a spreadsheet using the data from the first 1095C run that was saved to the table, and will not re-calculate the data.
Also: when UBACA is run for months that are in an employee’s Stability Period, no data is recalculated by UBACA, current data for the month will be copied from the data generated when the stability period was first initiated.
The 1095C and 1094C reports read from this data and do no further computation, so what you see in the VBACAE/IBACAE screens represent what will be output.
Important Note: There are no edits in this screen beyond the basics required for database integrity. You have the opportunity to enter any values that you wish, including the linking of employee contacts who may not be associated to the ACA-identified health plan. |
During this period UBACA will not recalculate hours worked or a wage rate to determine if the employee is FT or PT or whether the medical coverage is ‘Affordable.’ The employee’s ACA status is fixed as of this date and will extend to the end of the Stability Period when a new measurement period will determine the next stability date and ACA status. During a new employee’s UBACA processing, there will be no stability date entered until the last month of the look back period has been reached.
RB1095C will produce the form on blank 8½“ X11“ paper, and may be printed double sided (duplex)
RB1095SM will produce the form single sided on an 11” X 14” self-mailer form MW1095C (from RR Donnelley) or equivalent.
The 1095C form for employees is produced on blank paper using the RB1095C/RB1095SM program. This program reads the data from the VBACAE form and produces one page per employee (additional pages as required for overflow of dependents).
Report Parameters & Filters
Report Parameters | |
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Entity | Identify the entity you are producing 1095C forms for |
Year | Identify the year that you are producing 1095C forms for |
As of Date | This parameter is used to retrieve the current Assignment and Group information for an employee, as of the date provided. |
Corrected | If you set this value to “Yes” then the 1095C form will be printed with the check mark on the CORRECTED field. |
Interface Code | The name of the IDIF definition that is used to create the 1094C form/file. The HL supplied IDIF is HL$ACA-1094C. Details for this interface code can be found in this document on Page 15 in section IDIF – Defining values for the 1095C/1094C Forms and File |
Hide SSN | If set to “Y” then Social Security Numbers are obfuscated with leading “X”’s |
Sort By | How you want the 1095C forms to be sorted. You have these options://;Pay Destination + Department Code + Last Name//;Pay Destination + Last Name//;Auth Area + Last Name//;Last Name (this is the default if none of the above options are chosen) |
Report Filters | You may use these filters to produce a subset of 1095C forms for specific employees or groups of employees. |
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The RB1095C will produce a PDF file that contains a 1095C form for each employee. This may be printed on blank paper, and print the instructions on the back (if printing duplex). The RB1095SM will produce a PDF file that contains a 1095C form for each employee and may be printed on the MW1095C form from RR Donnelley. This is a self-mailer form and includes the instructions pre-printed on the back.
If necessary, a continuation page for Part III Covered Individuals will be printed following the 1095C form.
NOTE: You may apply for, and receive, a Transmitter Control Code (TCC) to eFile your ACA submission. You must also submit a test form to the IRS for approval of the file format.
Report Parameters & Filters
Report Parameters | |
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Entity | The entity code you are producing the 1094C report/file for |
Year | The reporting year you are producing the 1094C report/file for |
As of Date | This date is used to retrieve employee assignment and group demographic information. |
Corrected 1094C | If set to YES, the data on the 1094C file is indicated as a correction |
Corrected 1095C | If set to YES, the 1095C Correction indicator is turned on in the 1094C file |
Interface Code | The name of the IDIF definition that is used to create the 1094C form/file. The HL supplied IDIF is HL$ACA-1094C. Details for this interface code can be found in this document on Page 15 in section IDIF – Defining values for the 1095C/1094C Forms and File |
Directory Name | The name of the database server-centric directory where the 1094C file will be created. The file name has a fixed name format . |
Report Filters | You can use these filters to restrict the employees that are included in the 1094C report/file |
The 1094C File is named using the following naming convention
The full 1094C report is produced
Screen captures are meant to be indicative of the concept being presented and may not reflect the current screen design.
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