Wiki: UBACA

UBACA – Affordable Care Act Report#

This report is run on a monthly basis and will report on employee data for the year/month as defined in the Year (YYYY) and Month (MM) fields.

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:

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 messages
The REPORT tab will show the data in the report

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.

VBACAE – View ACA Monthly Data by EE #

The VBACAE is an employee form where the results of UBACA computations can be viewed. The UBACA report and 1094C/1095C reports get their data by reading this information.

IBACAE - Define ACA Monthly data by EE#

Data can be manually corrected in IBACAE, except for the Final toggle. The 1094C and 1095C reports read this data and does no further computations. Consequently, what you see in the VBACAE/IBACAE forms represent what will be output.

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 Year and Month fields are derived from the Year (YYYY) and Month (MM) fields on UBACA.

The ACA Category is read from the employee’s Group form or from the Assignment form, if an override exists.

The 'Enrolled in Plan/Coverage' field will show the current enrollment of the employee in the medical plan and coverage, if any.

The Line 14 box may contain one of the following codes, and will be printed on the 1095C accordingly:

Logic enhanced in switching 1E to 1A when ACA Wage Rule = 'PL'. Only switch to 1E if Offered Coverage is also 1E and it's ACA Monthly EE Prem <= 9.5% of federal poverty line.

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.

'Offered Plan/Coverage' will show the medical plan/coverage that has the lowest cost, offered to the employee.

'Coverage Rate' is the ACA Monthly EE Premium of the plan/coverage that has the lowest cost, offered to the employee.

'Wage Rate' is the rate of pay considered by ACA, depending on the ACA Wage Rule.

'Hours' is the calculated ACA worked hours, based on the ACA Hours Rule.

'FT' will be toggled ON if UBACA determines that the employee is Full Time (has worked an average of more than 130 hours per month).

The lower section of this form will show any dependents if:

The plan is designated as ACA Self Insured in IBPN, and
There are dependents defined on IECT with the 'Dependent' field set to YES, and
The dependents are associated with the Medical plan on IBRA at a coverage rate greater than 0 (or null).

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.

Determining Line 14 Codes#

The UBACA program will determine the Line 14 and Line 16 Codes for use in the 1094C/1095C forms and file. The codes below reflect the order that they are determined.

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).

Determining Line 16 Codes#

The UBACA program will determine the Line 14 and Line 16 Codes for use in the 1094C/1095C forms and file. The codes below reflect the order that they are determined

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