Potpourri of ACA Basics

What is the primary purpose of Section 6056 reporting?

Administer the employer shared responsibility provision (“employer mandate”) and used in determining eligibility of individuals for the Marketplace premium tax credits.

Administer the individual shared responsibility provision (“individual mandate”) by reporting minimum essential coverage (MEC).

Both

The ACA Employer Mandate (Section 6056) is comprised of which of the following tasks:

Lookback Reporting

Eligibility/Data Management

IRS Form Creation/Distribution/Filing

All of the Above

What is the ACA definition of a full-time employee?

An employee who works an average GREATER than 30 hours/week in a calendar month

An employee who works an average of 30 or MORE hours/week in a calendar month

An employee who works an average of 40 or MORE hours/week in a calendar month

What is the primary purpose of a Lookback Report?

To generate codes that determine the levels of coverage Employees are eligible for.

To manage private exchange subsidy notices.

To manage and identify possible medical eligibility changes within an organization.

All of the above.

All Applicable Large Employers are required to file their Lookback reports with the IRS.

True - The IRS requires Employers to provide this documentation at the end of each year.

False - While employers may be wise to document their efforts throughout the year, only 1094 & 1095 forms are ever filed with the IRS.

How are the Lookback Report and the 1094/1095 forms connected?

They are not related. The lookback report has no influence on what appears within the 1094 & 1095 forms

They are loosely related - Employers must file both requirements with the IRS on an annual basis.

The look-back report allows Employers to identify eligibility changes that directly affect the output of the 1094/1095 forms.

None of the above.

What is the Primary Difference Between a 1094 & 1095 Form?

There is no difference, they are the same.

1094 Forms Center on Individual breakouts of coverage. 1095 Forms are High level summaries/coversheets

1095 Forms Center on Individual breakouts of coverage. 1094 Forms are High level summaries/coversheets

What is the Primary Difference Between a 1095-B & 1095-C?

1095-B's answers the following question by month "did you enroll in coverage, yes or no"/ 1095-C asks the same question, but in addition communicates details on the type of coverage offered including price point and dependent eligibility.

Employers must always provide employees directly with a 1095-B. 1095-C is optional

The 1095-B is used for fully insured plans and primarily distributed by Insurance Carriers. 1095-C's are utilized in self-insured situations and are distributed by the Employer to their employees.

What is the Primary difference between the 1094-B & 1094-C

None, they both serve the same purpose.

The 1094-B is extremely detailed and provides high level counts of: Employee Information, FT employees, Total Employees & Safe Harbor Methods / The 1094-C is simply a cover sheet that communicates the number of 1095 -C forms included with the submission

The 1094-C is extremely detailed and provides high level counts of: Employer Information, FT employees, Total Employees & Safe Harbor Methods / The 1094-B is simply a cover sheet that communicates the number of 1095 -B forms included with the submission

My head hurts, none of the above.

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