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' rule, 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 defined.
UBACA will only process employees whose assignment employment status is Active, Pending, Leave, Unpaid Leave, Retired, Cobra and Terminated (up to the month of termination).
This report will generate a Microsoft Excel spreadsheet. This allows users to sort, manipulate and/or analyze data in the records.
Exception messages can be viewed in the Excel spreadsheet and Exception messages can always be viewed in DMEX, VMEXF, VMEX and RMEX.
UBACA Report Criteria
Field | Description | |
---|---|---|
Entity | Mandatory. Run UBACA for only one Entity at a time. | |
Year | Enter the year to report on | |
Month | Enter the month to report on | |
Use Eligibilty Date | Default (empty) is No. If this field is set to Yes, 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. Although this may suit an organization's set up better, note that there is no constraint or guarantee that eligibility dates are contiguous, without gaps or without overlap. If this parameter is defined, then only those records with the eligibility dates filled in will be reviewed. | |
Exception Level | Defines the level of detail to be printed. |
There are three tabs at the bottom of the spreadsheet:
Some key fields are:
Full Time | The determination if an 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 ACA reporting purposes, the employee is Part Time. Example: there will be a No in this field. |
Hours | If the IBACA ACA Hours Rule is 'Monthly Measurement' these are the hours worked in the month being reported. 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 | This is the medical benefit plan the employee is actually enrolled in on IBEN |
Enrolled Coverage | This is the medical benefit plan coverage the employee is enrolled in on IBEN |
Line 14 Code | This is the Line 14 code relating to the employee for the reported month |
Line 16 Code | This is the Line 16 code relating to the employee for the reported month |
Offered Plan | This is the medical plan that has the lowest cost for the employee. This may not be the same as the enrolled plan, as this information is coming from IBSC. |
Offered Coverage | This is the medical plan's self-only coverage that has the lowest cost for the employee. This may not be the same as the enrolled plan, as this information is coming from IBSC. |
Coverage Rate | This is derived from the 'ACA Monthly EE Prem' field on IBPN, 'Coverage' tab, with the ACA Min. Value Self toggle. This will be the same for all employees enrolled in the same Plan on IBSC. |
Affordability | This is derived by the UBACA calculations. The Yes/No option in this column is determined by the calculation done by UBACA. If 9.86% of the Wage Rate is less than the Cost, then the plan is not affordable and a No is populated in this field. |
If a plan is self-insured and the employee has dependent children, this information will be shown on the report. Up to 4 dependents can be shown on the report. All dependents are stored in the database and will be reported on the 1095C report, and are shown on the VBACAE form.
IMPORTANT NOTE: There are no edits on this form beyond the basics required for database integrity. Users can enter any values they wish, including linking employee contacts who may not be associated to the ACA-identified health plan.
The Line 14 box may contain one of the following codes, and will be printed on the 1095C accordingly:
Code | Description |
---|---|
1A | Qualifying Offer: Minimum essential coverage providing minimum value offered to a full-time employee with employee contribution for self-only coverage equal to or less than 9.5% mainland single federal poverty line and at least minimum essential coverage offered to spouse and dependent(s). |
1B | Minimum essential coverage providing minimum value offered to employee only. |
1C | Minimum essential coverage providing minimum value offered to employee and at least minimum essential coverage offered to dependent(s), (not spouse). |
1D | Minimum essential coverage providing minimum value offered to employee and at least minimum essential coverage offered to spouse, (not dependent(s)). |
1E | Minimum essential coverage providing minimum value offered to employee and at least minimum essential coverage offered to dependent(s) and spouse. |
1F | Minimum essential coverage NOT providing minimum value offered to employee, or employee and spouse or dependent(s), or employee, spouse and dependents. NOTE: Code 1F is not currently set by the UBACA process and must be manually set on IBACAE. |
1G | Offer of coverage to employee who was not a full-time employee for any month of the calendar year, and who enrolled in self-insured coverage for one or more months of the calendar year. |
1H | No offer of coverage (employee not offered any health coverage or employee offered coverage that is not minimum essential coverage). This is set on IEAS. NOTE: An employee who is Terminated and offered a COBRA/Retiree continuation coverage would have Line 14 = 1H and Line 16 = 2B during the fist month of retirement (transition from Active to Retiree). During the month that the employee is a Retireee for the whole month, Line 14 = 1H and Line 16 = 2A. |
1J | Minimum essential coverage providing minimum value offered to employee and at least minimum essential coverage conditionally offered to spouse, minimum essential coverage not offered to dependent(s). |
1K | Minimum essential coverage providing minimum value offered to employee, at least minimum essential coverage offered to dependent(s), and at least minimum essential coverage conditionally offered to spouse. |
The Line 16 box may contain one of the following codes, and will be printed in the 1095C accordingly:
2A | Employee was not employed during the month |
2B | Employee is not a full-time employee |
2C | Employee is enrolled in coverage offered |
2D | Employee in a section 4980H(b) Limited Non-Assessment Period. Enter code 2D for any month during which an employee is in a Limited Non-Assessment Period for section 4980H(b). |
2E | Multi-employer interim rule relief. Enter code 2E for any month that the multi-employer interim guidance applies for the employee. |
2F | Section 4980H affordability Form W-2 safe harbor |
2G | Section 4980H affordability federal poverty line safe harbor |
2H | Section 4980H affordability rate of pay safe harbor |
2D and 2E, above, are not currently set by the UBACA process and must be manually entered in IBACAE.
IMPORTANT NOTE: Line 16 will be blank for any month that the ALE member did not offer minimum essential coverage to at least 95% of its full-time employees and their dependents.
The 'ACA Period' is populated by UBACA only when a look-back measurement period is selected for the employee. The options are:
ACA Period | Description | |
---|---|---|
Administration Period | For ongoing employees, this is the period following the end of the measurement period and ending immediately before the stability period. | |
Initial Period | For new hires, starting on the fourth full calendar month to the end of the Lookback month. | |
Non Assessment Period | For new hires, their first partial month and their first three full calendar months. | |
Stability Period | A full time employee is put into a stability period for the duration of one year, based upon the date that is stamped in IEEI. To remove an employee from a stability period, remove this date. When an employee is in a stability period, no computations are made to hours worked or wages, as the previous month’s values will be used. NOTE: After completing the previous year for Look Back category, this date will be used going forward. | |
Standard Measurement Period | A period defined by the employer of at least three consecutive months, but not more than 12 consecutive months, used as a part of the Look Back measurement period. |
The lower section of this form will show any dependents if:
NOTE: When UBACA is run for the 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.
NOTE: 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 a user has previously processed a month with this option set to YES, then subsequent runs with the flag set 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 if users 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 set to ON, UBACA does not go through the data for that month, but rather simply reports on the data that is in the database.
Users do not need to run UBACA with this toggle set to YES in order to produce 1095C/1094C output.
This report will generate a Microsoft Excel spreadsheet. This allows users to sort, manipulate and/or analyze data in the records.
SITUATION | Line 14 Code | |
---|---|---|
IEAS Excluded flag is set to any value. | IH | |
Employee is terminated prior to the first of the month and they are not in an employment status of COBRA or Retiree | 1H | |
Employee is hired this month and is therefore in the initial measurement period. | 1H | |
Employee who is terminated and offered a COBRA/Retiree continuation coverage. | 1H | |
Employee (not Cobra/Retiree) is enrolled in a IBPN coverage defined with 1E, but wage rule is set to Federal Poverty Line (FPL). | 1A | |
Employee (not Cobra/Retiree) is enrolled in a IBPN coverage, is part time for all 12 months, and the policy is a Self-Insured policy | 1G will be reported on the 1095C form but may have a different value on VBACAE. This value comes from IBPN coverage of highest offer (1A, 1B, 1C, 1D, 1E, 1G, 1H). | |
Employee (not Cobra/Retiree) is not offered any plan from IBSC. | 1H | |
Employee (not Cobra/Retiree) is enrolled in a benefit plan. | This value comes from IBPN coverage of highest offer (1A, 1B, 1C, 1D, 1E, 1G, 1H). |
SITUATION | Line 16 Code | |
---|---|---|
IEAS Excluded flag is set to any value. | Blank | |
For any month that the ALE member did not offer minimum essential coverage to at least 95% of its full-time employees and their dependents | Blank | |
Employee is terminated prior to the first day of the month and they are not in an employment status of COBRA or Retireee | 2A | |
Employee is hired this month and is therefore in the initial measurement period. | 2D | |
Employee who is terminated and offered a COBRA/Retiree continuation coverage. | 2A, except for the transition month, which will be 2B | |
Employee is in a Non Assessment Period, Initial Period or Administration Period | 2D | |
Employee is enrolled in any benefit plan (not only the minimum value self-only offer) | 2C | |
Employee (not Cobra/Retiree) is part time and not enrolled in the minimum coverage offered (may be other coverage) | 2B | |
Employee is offered coverage deemed affordable according to the Form W2 Wages rule, but is not enrolled in any plan | 2F | |
Employee is offered coverage deemed affordable according to the Federal Poverty Line rule, but is not enrolled in any plan | 2G | |
Employee is offered coverage deemed affordable according to the Rate of pay rule, but is not enrolled in any plan | 2H | |
Employee is not enrolled in a plan, were terminated within the month and are not full time | 2B | |
Employee was terminated prior to this month and is not enrolled in a plan | 2A |
Important Note: Note that if the UBACA is run for the same employee, for the same month and year, it will wipe out all changes made manually on this form.
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 | |
---|---|
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.
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.
Important Note: It is recommended that you make a copy of the IDIF interface definition from the HL$ACA-1094C for your own site, so as to preserve your values on this and subsequent updates.
Report Parameters & Filters
Report Parameters | |
---|---|
Entity | The entity code you are producing the 1094C report/file for |
Year | The reporting year you are producing the 1094C report/file for |
As of Date | This date is used to retrieve employee assignment and group demographic information. |
Corrected 1094C | If set to YES, the data on the 1094C file is indicated as a correction |
Corrected 1095C | If set to YES, the 1095C Correction indicator is turned on in the 1094C file |
Interface Code | The name of the IDIF definition that is used to create the 1094C form/file. The HL supplied IDIF is HL$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.
If you have any comments or questions please email the Wiki Editor
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