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IRS Releases Sample Letter 226J – Sheds More Light on Employer Mandate Penalty Enforcement

The IRS took another big step in the enforcement of the employer mandate penalty by releasing a sample Letter 226J. As discussed in a previous article, the IRS plans to provide a Letter 226J to each Applicable Large Employer member (ALE member) it believes owes an employer mandate penalty (or an Employer Shared Responsibility Payment (ESRP) as the Letter 226J references the penalty). This article discusses what new items the IRS disclosed in the sample Letter 226J.

The Wolf Is Coming – IRS Updates Q&A regarding Procedures for Employer Mandate Enforcement

Last week we wrote about the Boston Business Journal reporting, the employer mandate penalty notices would soon be sent by the IRS. While many may view this as the boy crying wolf yet again, the IRS has updated its Questions and Answers on Employer Shared Responsibility Provisions Under the Affordable Care Act to expound upon the questions related to Making an Employer Shared Responsibility Payment (see questions 55 through 58). The procedures which were updated on November 2, 2017 are the IRS’ strongest signal that the employer mandate penalties are imminent. This article describes the details the IRS has provided regarding the enforcement of the employer mandate penalties and the corresponding appeals procedures.

Business Journal Reports Employer Mandate Penalties to be Issued in November

Last week, the Boston Business Journal, citing unnamed IRS and White House officials, reported that the IRS would be issuing employer mandate penalty notices in November. If the report is true, this would continue the IRS’ more stringent enforcement of the Affordable Care Act (ACA) in 2017 as previously discussed in articles regarding the IRS enforcing each Applicable Large Employer member (ALE member) filing its own Form 1094-C and the IRS requiring the ACA information to be completed on individual tax returns for the 2017 calendar year. This article explores some scenarios as to why the IRS may be contacting an employer with an employer mandate penalty notice.

IRS Begins to Draw the Line in the Sand – Won’t Accept Individual Tax Returns without ACA Information

Last week the IRS released a statement on the IRS website informing the public that it would not accept individual tax returns in 2017 that did not indicate whether the individual had health coverage, had an exemption from the individual mandate, or will make a shared responsibility payment under the individual mandate. Therefore, for the first time, an individual must complete line 61 (as shown in previous iterations) of the Form 1040 when filing his/her tax return. This article explains what the new IRS position means for the future of ACA compliance from an employer’s perspective.

It is Illegal for a Standard Measurement Period to Start on October 1 – Manipulation is Needed for that Start Date

Employers who sponsor a calendar year plan and who have adopted the <a href=" https://accord-aca.com/articles/the-look-back-measurement-method-ongoing-employees" target="_blank">look back measurement method</a> will soon be reaching the end date of the standard measurement period. Just as in previous years, this has brought to my attention a lingering problem with the setup of many employers standard measurement periods. Unfortunately, many employers have setup standard measurement periods that start prior to October 3 of the particular year in question, in this case October 3, 2016. This article explains why starting a standard measurement period prior to October 3 creates a problem and addresses a few potential solutions.

The Problem and Solution of a Controlled Group Incorrectly Filing Only One Form 1094-C

Over the past six months many employers have received notifications from the IRS that they have failed to file the Forms 1094-C and 1095-C with the IRS. This type of noncompliance is often due to the employer failing to file a Form 1094-C for each Applicable Large Employer (ALE) member. The instructions to the Form 1094-C are clear that each ALE member must file a Form 1094-C. However, many employers only filed one Form 1094-C for all of its ALE members. Employers who filed in this manner are receiving letters from the IRS inquiring where the Forms 1094-C are for the employer’s other ALE members.

Forms 1094-C and 1095-C Draft Instructions Released – Minimal Changes But Problems Still Exist

Last week the draft instructions to the Forms 1094-C and 1095-C were released with minimal changes compared to the final instructions from 2016. Most of the changes made in the draft instructions are the elimination of discussions related to the transition relief provisions that applied in previous years, but can never apply for the 2017 Forms. Pleasantly this makes the instructions a bit shorter yet just as fun to read. This article provides a brief summary to the changes and new notes added to the draft instructions for the Forms 1094-C and 1095-C, discusses key dates, and provides a brief overview of penalties associated with the Forms. The article concludes by discussing a problem that persists related to the code 2F on line 16 of the Form 1095-C.

Careful – The Affordability Test is More Restrictive on Employers in 2018

Open enrollment season is fast approaching so every employer will need to begin to finalize the prices of the plan or plans that it will offer its employees. In order to avoid a potential section 4980H(b) penalty an employer must make sure one of its plans provides minimum value and is offered at an affordable price. An actuary will determine whether the minimum value threshold has been satisfied and this is generally not an issue for employers. However, an employer is in control as to whether the plan it is offering meets the affordability threshold.

Little Known Fact – Sections 4980H(a) and 4980H(b) Penalty Amounts Already Finalized for 2018

A few weeks back I was curious as to what the adjusted section 4980H(a) and (b) penalty amounts related to the employer mandate would be in 2018. After all we are getting late in 2017 and employers will soon need to make final decisions as to their coverage options for the 2018 calendar year. After thoroughly reviewing the IRS website and looking elsewhere we discovered there has been virtually nothing written about the section 4980H penalty amounts for 2018. Fortunately, after reading the Code and figuring out what the premium adjustment percentage was for 2018 it is easy to determine the penalty amounts for 2018. This article explains the Code provision and the math behind the 2018 penalties.

IRS Continues to Provide Clues About 2017 Forms 1094-C and 1095-C – Not Much has Changed

On August 14, 2017 the IRS released its second iteration of the draft Form 1095-C for 2017. Previously on July 27, 2017, the IRS had released draft copies of both the Forms 1094-C and 1095-C. We anticipate the instructions to the Forms 1094-C and 1095-C to be released any day. However, as the reporting season is fast approaching, here is a brief summary of what we have learned from the draft Forms released to date.

Reporting Obligation and Employer Mandate Still Apply

When John McCain cast his no vote on the latest health care bill another Republican plan to repeal and replace the Affordable Care Act was essentially defeated. This has been a recurring theme for all of the bills that have been stuck in Congress over the last five months. All the bills debated and voted upon by both the House and Senate have cast a cloud of confusion over what an employer must do to comply with the ACA. The purpose of this article is to provide an overview of what the current law requires for the 2017 reporting season and things to keep in mind for the 2018 open enrollment period.

Expensive Problems Occurring for Employers Who Don’t Have Clear Health Plan Eligibility Conditions

Employers are now two and half years into operating in the employer mandate world. The employer mandate caused many employers to amend the eligibility conditions for their health plans to avoid potential penalties. Unfortunately, some employers are failing to document the eligibility conditions for their health plans. Other employers have documented their health plan’s eligibility conditions but failed to coordinate the eligibility conditions with their insurance company. These two oversights are starting to cause employers expensive problems. This article explores the dangers of not documenting and coordinating the eligibility conditions of an employer’s health plan.

Incorrect TINs – An Employer’s Nightmare Returns with the 2016 Form 1095-C Reporting Season

Just like the 2015 reporting season, one of the most common errors employers received when submitting the Form 1094-C/Form 1095-C packet for the 2016 reporting season was an error message stating there is an incorrect taxpayer identification number (TIN). As many learned last year, the TIN error could be a result of incorrect data entry, a marriage that occurred midyear changing the last name of an individual, but frequently was caused for no apparent reason. This article is intended to explain how the IRS software searches TINs, the improvements that have been made, and what an employer needs to do if it received an error message indicating there is a TIN issue with one (or more) of the Forms 1095-C it submitted to the IRS. The good news is an employer still does not need to go through the solicitation process if it receives a TIN error message for an incorrect TIN! A recent conversation with the IRS reaffirmed this position.

Five Items to Consider if You are Assessed an Employer Mandate Penalty

It is possible we have finally arrived at the month in which the IRS will begin to assess penalties against employers who fell short of the employer mandate standards under the Affordable Care Act (ACA). Speculation that employer mandate penalties may be assessed in May 2017 are largely based on the recently released TIGTA audit report which referenced several IRS tools required to assess the penalties being launched in May 2017. As a result, a publication explaining how an employer should handle a potential penalty from the IRS is appropriate at this time.

Audit Shows the IRS is Struggling with the Technology Needed to Enforce the ACA Employer Mandate

On April 7, 2017 the Treasury Inspector General for Tax Administration (TIGTA) released its findings from its audit conducted to assess the IRS’s ability to ensure compliance with the Affordable Care Act’s (ACA) employer mandate. The audit discovered several major issues with the technology being used to assist the IRS enforce the employer mandate. The technological trouble the IRS is experiencing is undoubtedly one of the reasons the IRS has not penalized a single employer under the employer mandate. This article briefly explores some of the issues discussed in the audit report and how an employer should use the findings of the report in the future.

Five Items Employers Should Know About the Repeal and Replace of Health-Related Tax Policy Bill

On Monday March 6, 2017 the Republicans released a bill that would repeal and replace certain provisions of the Affordable Care Act (ACA). The bill has faced harsh criticism from both Democrats and certain Republicans and as currently constructed is unlikely to pass. Nonetheless, it is the first step in the process of repealing or amending the ACA which still appears inevitable under the country’s current leadership. This article provides a brief summary of five items employers should be aware of in the bill.

Not Ready to File the Forms 1094-C and 1095-C with the IRS? How to File an Extension

The deadline to file the Forms 1094-C and 1095-C for paper filers, February 28, 2017, is only days away. An employer who has elected to, or is required to, file electronically will have until March 31, 2017 to file the Forms 1094-C and 1095-C. If an employer is not prepared by the requisite deadline, the employer may receive an automatic 30 day extension by filing a Form 8809 with the IRS. This extends the paper deadline until March 30, 2017 and the electronic deadline to May 1, 2017. This article provides basic instructions regarding how an employer should complete the Form 8809.

Five Important Things to Remember for the Forms 1094-C and 1095-C Filing Season

If an employer has not already done so, it will soon be completing the Forms 1094-C and 1095-C for the 2016 calendar year. Despite being the second year these Forms are required to be filed by Applicable Large Employers (ALE), there is still a significant amount of confusion surrounding the deadlines and details related to the Forms. This article is intended to provide a reminder of five important issues related to the Forms 1094-C and 1095-C.

ACA Repeal Could Lead to More Complicated Regulations for Employers

President Trump and the Republicans have made it clear that changes are coming to the Affordable Care Act (ACA). Congress has already taken preliminary, complicated steps through budgetary reconciliation to repeal key parts of the ACA and President Trump signed an executive order calling for a prompt repeal of the ACA. While neither action impacts an employer’s obligation to file the Forms 1094-C and 1095-C in 2016, all indications are significant changes are coming to the ACA in the future. On the surface, a repeal of the ACA appears to provide employers relief from complicated, burdensome regulations. However, examining recent benefit trends and the pre-ACA landscape, employers could be in store for a flood of complicated State and local laws if the ACA is repealed.

Deadline to Furnish Form 1095-C Employee Statements Approaching – Unlikely to Change if ACA is Repealed

Tomorrow, January 20, 2017, President Trump will officially take office. This has led many to speculate on the immediate demise of the Affordable Care Act (ACA). While changes to the ACA are assuredly coming, these changes are unlikely to impact the 2016 ACA reporting requirements. The deadline for employers to furnish the Form 1095-C employee statements is March 2, 2017. If an employer has not already begun the process of completing a Form 1095-C for its applicable employees, there is not much time left to accurately complete lines 14, 15, and 16, print and address the Forms, and place the Forms in the mail.

HHS Appeals – Are There Any Losers?

Employers have recently begun to hear back from the Department of Health and Human Services (HHS) regarding their appeal of the section 1411 notices they received. Many employers have been surprised to learn their appeal was unsuccessful with HHS as they offered the employee in question minimum value coverage at an affordable price under the Affordable Care Act’s (ACA) standard for each month of the 2016 calendar year. For better or worse, an unsuccessful HHS appeal is the end of the HHS appeals process for an employer. Therefore, the employer is stuck with the adverse HHS decision. This article explains why employers experiencing an unsuccessful HHS do not need worry and instead should be thankful as everyone is winning from the employer’s perspective in the scenario.

Rescinding Coverage from a Full-Time Employee during a Stability Period: Legal, but Fraught with Danger

We recently worked with an employer who was utilizing the look back measurement method to the fullest extent. The employer had the intention of rescinding coverage to certain ongoing full-time employees. While this strategy is certainly possible, there are many hoops an employer executing this strategy must jump through to accomplish this task. This article explains how an employer can execute this strategy, but explains why it is not worth the cost for all but the largest of employers.

Form 1095-C Deadline for Furnishing Statements to Individuals Extended along with Good Faith Efforts Standard

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The Election of President Trump Does Not Give Employers a Free Pass on 2016 ACA Reporting

The election of President Trump on Wednesday morning created new complications and uncertainty in the already complex world of the Affordable Care Act and, in particular, ACA compliance in 2016. In this article we explore the four possible outcomes that may occur with regard to 2016 reporting. As the math below shows, the logical choice for all employers is compliance with the ACA reporting requirements in 2016.

Final Instructions Make it Impossible to Tell an Accurate Narrative on Each Form 1095-C

We recently performed an audit on our software to make sure the automation process was working properly in light of the updated language in the final instructions to the Forms 1094-C and 1095-C. Particular attention was paid to lines 14, 15, and 16 of the Form 1095-C. These three lines are one of the main tools the government uses to assess the section 4980H penalties against an employer. Lines 14, 15, and 16 tell the government a 12 chapter narrative about the employee entered on the Form 1095-C.

Final Instructions to Forms 1094-C and 1095-C Released – Five Key Takeaways

Earlier this week the final instructions to the Forms 1094-C and 1095-C were released. We have previously written two articles separately discussing how the draft instructions impact the Form 1094-C and the Form 1095-C. The points made in each of these articles remain valid as the final instructions do not change anything of substance from the draft instructions. The remainder of this article discusses a few points the final instructions emphasized and provides five key takeaways from the 2016 final instructions.

The Look Back Measurement Method – Ongoing Employees

Despite almost being two years into the Play or Pay provision of the Affordable Care Act (ACA) there is still confusion surrounding some aspects of the complex provision. The ACA provides an employer the option to offer 95 percent of its full-time employees minimum essential coverage or risk paying a section 4980H penalty. If the look back measurement method is adopted, an employee can be classified as a full-time employee, a part-time employee, a variable hour employee, a seasonal employee, or an ongoing employee. The remainder of this publication reviews the rules of the look back measurement method as it relates to ongoing employees. Previous publications detailed the rules for the other four categories of employees.

The Look Back Measurement Method – Part-Time, Variable Hour, and Seasonal Employees

Despite almost being two years into the Play or Pay provision of the Affordable Care Act (ACA) there is still confusion surrounding some aspects of the complex provision. The ACA provides an employer the option to offer 95 percent of its full-time employees minimum essential coverage or risk paying a section 4980H penalty. For section 4980H purposes, a full-time employee is an employee who averages at least 30 hours of service per week. An employer can treat 130 hours of service as the monthly equivalent of 30 hours per week. Additionally, an employer has the option to adopt the look back measurement method. The logical choice for almost every employer is to adopt the optional look back measurement method to track its employees’ hours of service. This publication is the second part of a three part series. All of the points, such as documenting the look back measurement method and counting hours of service, discussed in first part of the three part series are relevant for the second part. A future publication will detail the rules for the last category, ongoing employees.

The Look Back Measurement Method – Full-Time Employees

Despite almost being two years into the Play or Pay provision of the Affordable Care Act (ACA) there is still confusion surrounding some aspects of the complex provision. The ACA provides an employer the option to offer 95 percent of its full-time employees minimum essential coverage or risk paying a section 4980H penalty. If the look back measurement method is adopted, an employee can be classified as a full-time employee, a part-time employee, a variable hour employee, a seasonal employee, or an ongoing employee. The remainder of this publication reviews the rules of the look back measurement method as it relates to full-time employees and some basic features of the look back measurement method. Future publications will detail the rules for the other four categories of employees.

An Overview of Reminders and Changes to the Form 1094-C from the 2016 Draft Instruction

In early August the draft instructions were released for the Forms 1094-C and 1095-C for 2016. While not much has changed, there are some differences in the Forms compared to 2015 and the IRS emphasized certain areas we assume many filers struggled with in 2015. This article is intended to provide an overview of the changes, provide helpful reminders, and point out things the IRS emphasized in the instructions to the Form 1094-C. Read more at accord-aca.com

An Overview of Reminders and Changes to the Form 1095-C from the 2016 Draft Instruction

In early August the draft instructions were released for the Forms 1094-C and 1095-C for 2016. While not much pertinent has changed, there are some differences in the Forms compared to 2015. This article is intended to provide an overview of the changes, provide helpful reminders, and point out things the IRS emphasized in the instructions to the Form 1095-C. Read more at accord-aca.com

Conversation with IRS Clarifies Confusion with Regard to Incorrect TINs

Earlier this week we caught up with a knowledgeable person at the IRS regarding an employer’s solicitation obligations for an incorrect taxpayer identification number. Almost every employer who submitted a packet of Form 1095-Cs received an AIRTN500 error message for at least one of the Form 1095-Cs.

Incorrect TINs - A Workable Solution for the Dreaded AIRTN500 Error Message

One common error an employer received from the Affordable Care Act Information Return system when submitting a packet of Form 1095-Cs was an error reporting that a Form 1095-C was submitted with an incorrect taxpayer identification number. The error code displayed when this occurs is AIRTN500 which signifies an individual name and TIN does not match the IRS database.

Proposed Regulations Clarify TIN Responsibilities and Create New Important Questions

On August 2, 2016 the IRS published in the Federal Register proposed regulations which among other things attempt to clarify the confusion regarding taxpayer identification number solicitations. This is the government’s third attempt to clarify the issue since the creation of IRC section 6055.

The Beautiful, Rhythmic Beat of Seasonal Employees under the Affordable Care Act

Many employers have struggled to apply the rules discussed in the Affordable Care Act, often complaining that the rules are too complex and create too much work. We understand that initially the rules can be burdensome and hard to apply. However, we have great news for employers with seasonal employees. Seasonal employees are almost always going to be treated the exact same way and no Form 1095-C will need to be reported for the typical seasonal employee.

How accurate were the form 1095-C’s you submitted to the IRS in 2015 – we can tell you

To assist employers with this complex issue Accord created Form Patrol which does not allow an employer to submit a Form 1095-C with impossible code combinations. We believe accurate line 14, 15, and 16 codes combinations is an obligation an employer has in order to fulfill its good faith efforts standard for the 2015 calendar year.

Don’t Accept – “Accepted with Errors” - How to Handle Incorrect TINs

One of the most common errors employers are receiving when submitting the Form 1094-C/Form 1095-C packet is an error message stating there is an incorrect taxpayer identification number. The incorrect TINs could be a result of incorrect data entry, a marriage that occurred during the year changing the employee’s last name which no longer matches the system the federal government uses, or an employee intentionally falsifying his/her TIN. Regardless of the reason, an employer needs to take appropriate steps to avoid a penalty for filing a Form 1095-C with incorrect information.

Affordability – A Guide to the Affordability Safe Harbors in 2016

The best way for an employer to fully protect itself from a 4980H penalty is to offer coverage that provides minimum value at an affordable price to all of its full-time employees and their dependents. This article explores how an employer can ensure that its offer of coverage will be deemed affordable. Read more at accord-aca.com.