The Affordable Care Act (ACA) has reshaped the healthcare landscape, introducing a number of daunting compliance challenges in the process. Navigating the ACA compliance landscape can be challenging, even for…
ACA Compliance
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The landscape of the Affordable Care Act (ACA) has been witnessing significant shifts, particularly concerning subsidies and their implications. We’ve recently explored how IRS safe harbors for affordability help businesses…
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Summer is upon us and with it come a number of opportunities, and risks, for employers. One critical area of risk is ACA compliance. The summer months mark a critical…
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ACA compliance has been a complex, time-consuming, and costly endeavor for employers across the country, and compliance isn’t made any easier by the fact that ACA requirements are dynamic and…
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Summer is upon us and with it a number of annoyances. Mosquitos. Road construction. And those pesky Affordable Care Act (ACA) compliance responsibilities that tend to slip during summer months…
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While the Affordable Care Act’s Employer Mandate is likely very well known (if not well loved) by employers, many are unaware of the ACA’s Rule of Parity, which offers some…
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Classifying workers correctly is critical for determining if the requirements of the ACA’s Employer Mandate apply to an organization. The reason? Worker classifications directly impact an employer’s Applicable Large Employer…
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It’s no secret the IRS is ramping up ACA enforcement. With additional funding for improving its tax correspondence processing infrastructure, more staff than ever, and a renewed focus on compliance,…
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The deadline for electronically filing ACA forms 1094-C and 1095-C for the 2022 tax year was March 31. Did you make the deadline? If you did, were all your submissions…
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It’s no secret that IRS enforcement is ramping up. With an additional $80 billion in funding and 87,000 new agents, employers should accept the fact that ACA penalties could be…
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ACA Full-Time: What is it and Why Does it Matter? What constitutes a full-time employee under the ACA? The answer is not as simple as it seems. And getting your…
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Now that the IRS received an influx of resources, including $80 billion in funding and 87,000 new tax agents, employers should keep their eyes peeled for the ACA warning notice,…
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If you or someone you know has been hit with IRS Letter 226J, you know that it is no laughing matter. The IRS is currently issuing these ACA penalty assessments…
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The responsibilities under the ACA’s Employer Mandate may seem straightforward, but, in reality, complying with them can be challenging and time-consuming. An area that many Applicable Large Employers (ALEs) struggle…
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ACA Compliance
4 Ways ACA Preventive Care Provisions Will Change if New Proposed Rules Pass
by Robert Sheenby Robert SheenA set of proposed rules issued by the Internal Revenue Service, Employee Benefits Security Administration, the Centers for Medicare and Medicaid Services, earlier this month aims to expand free access…
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There are many factors at play when determining which company shoulders the responsibility of ACA reporting falls on during a merger or acquisition. Ultimately, ACA reporting requirements are the obligation…
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The Centers for Medicare and Medicaid Services (CMS) are opening a special ACA enrollment period for beneficiaries losing Medicaid or Children’s Health Insurance Program (CHIP) coverage. The special enrollment period…
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It’s time to prepare ACA state filings for the 2022 tax year. Is your organization ready? As a reminder, on an annual basis, employers must file Forms 1094-C and 1095-C…
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ACA Compliance
There’s Been an Uptick in ACA Enrollment – Here’s Why
by Robert Sheenby Robert SheenRecord numbers of Americans are enrolling in affordable healthcare through state and federal marketplaces. Nearly 16 million Americans have signed up for individual market health insurance coverage since November 1,…
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The Department of Labor (DOL) and IRS recently issued an updated memorandum of understanding (MOU) regarding the way the two agencies identify and enforce employee misclassifications. The agencies make clear…
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ACA Compliance
AIR Portal Opens for 2022: Time to Review ACA Filings
by Robert Sheenby Robert SheenEarlier this week the IRS announced that the Affordable Care Act Information Returns (AIR) portal will open tomorrow, Friday, January 13, 2023, at 6:00 a.m. Pacific time. As a result…
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The arrival of a new year marks the time to begin preparing annual 1095-C filings with the IRS and select state governments. Fortunately for employers, there aren’t any new 1095-C…
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In late 2022, the IRS issued an update regarding Patient-Centered Outcomes Research Institute (PCORI) fees for 2023. Namely, that they are increasing. For plans that end on or after October…
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Late last week, the IRS issued the final ACA reporting instructions for the 2022 tax year, which include both the 1094-C and 1095-C forms to be filed and furnished in…
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We recently held a webinar regarding changes pertinent to the 2023 ACA reporting season. After receiving numerous questions from attendees during the event, we thought it best to compile them…
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Employers with operations in California should be familiar with the state’s Individual Mandate and the additional ACA reporting requirements, as they have been in effect since 2020. Still, organizations are…
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Understanding the details of the employer-shared responsibility provisions under the ACA can be challenging, especially as the IRS continues to issue penalties for non-compliance. One of the first steps is…
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ACA Compliance
South Dakota Medicaid Expansion on The Ballot This Fall
by Robert Sheenby Robert SheenThe ACA may broaden again this fall as voters decide whether South Dakota should join 38 other states in expanding Medicaid. Despite Republican pushback from legislators, South Dakota would follow…
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As IRS enforcement of the ACA continues to ramp up, organizations would be wise to implement a monthly compliance process, if they haven’t already. Employers that implement a monthly ACA…
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Determining the accurate full-time employee count during a calendar year is important for ACA compliance. Getting it wrong can lead to inaccurate annual information filings with the IRS and subsequently…
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ACA ComplianceACA Penalties
These Common Mistakes Can Result in ACA Penalties
by Robert Sheenby Robert SheenWithout the right resources, managing ACA compliance responsibilities can be time-consuming and difficult. There are many issues that can arise during the course of the year that can make employers’…
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ACA Compliance
ACA Affordability Drops to Historic Low for 2023 Tax Year
by Robert Sheenby Robert SheenLast week the IRS announced the affordability percentage for Premium Tax Credits (PTCs) and employee contributions for employer-sponsored health coverage. In IRS Rev. Proc 2022-34, the agency makes clear that…
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The words “summer” and “vacation” often go together. Applicable Large Employers (ALEs) should note that even though their ACA filing responsibilities have likely been satisfied due to the deadlines in…
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Last month the IRS published a proposed regulation that would amend the existing rule regarding employer-sponsored Minimum Essential Coverage (MEC) for family members of an employee. The proposed rule would…
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ACA ComplianceAffordable Care Act
5 Common ACA Compliance Mistakes Restaurants Make
by Robert Sheenby Robert SheenOver 10 years after the ACA was first signed into law, the reporting requirements under the ACA’s Employer Mandate have proven challenging and time-consuming for most. But quick-service restaurants have…
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With the 2021 ACA reporting season coming to an end later this month, employers should turn their attention to ACA compliance for the 2022 tax year. A key component of…
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ACA Compliance
IRS Increasing Staff to Clear Backlog and Support Current Tax Season
by Robert Sheenby Robert SheenOn March 10, the Treasury issued a statement announcing that the IRS will be hiring more than 10,000 positions to assist with its current backlog and the 2021 filing season.…
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Earlier this month the IRS issued a notice indicating that the fees associated with Patient-Centered Outcomes Research Institute (PCORI) are increasing this year. For plans that end on or after…
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On December 5, the IRS closed production of the Affordable Care Act’s Information Returns (AIRs) portal to prepare for 2021 reporting year electronic filing submissions. The agency says that the…
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Open enrollment for the 2022 plan year ends later this week but ACA signups are already hitting record new highs. Kaiser Health News cites a record-breaking 13.6 million Americans already…
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It’s 2022 and time to begin preparing the annual 1095-C filings with the IRS and select state governments. Are you ready? If you need a refresher on the different 1095-C…
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On December 9, 2021, the IRS published the final ACA reporting instructions for the 2021 tax year, including the final 1094-C and 1095-C forms. As expected, the forms and instructions…
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Open enrollment period for the 2022 coverage year is well underway, and ACA premiums are continuing to drop. The federal period for obtaining health coverage kicked off on November 1…
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ACA ComplianceACA Reform
How Build Back Back Better Would Reshape U.S. Healthcare
by Robert Sheenby Robert SheenWith the Infrastructure Bill now officially signed into law, Congress will now shift its focus onto the $1.75 trillion Build Back Better proposal. In its current version, the plan could…
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ACA ComplianceACA Reporting
Have a Handle on ACA Compliance? Let ACA Vitals Decide
by Chris Areyby Chris AreyACA reporting is heading into its seventh year, yet, many organizations still face significant obstacles to meeting the requirements of the ACA’s Employer Mandate. Under the ACA’s Employer Mandate, employers…
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Every year employers must file their ACA information via forms 1094-C and 1095-C to the IRS and any state government. For the last seven years, there have been two methods…
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With the end of the year approaching quickly, ACA compliance and the subsequent ACA reporting are ramping up. Employers preparing for IRS and state filing requirements should consider the importance…
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Three states have successfully transitioned away from the federal healthcare.gov ACA exchange to operate on their own-state run marketplace. On October 4, Maine, New Mexico, and Kentucky completed the transition…
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ACA ComplianceAffordable Care Act
Data Quality Management Is Key to ACA Compliance
by Robert Sheenby Robert SheenMany of the challenges posed by the Affordable Care Act’s Employer Mandate are inherently data problems. Data quality management is not just an issue for larger employers with multiple HR…
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Missouri’s ACA Medicaid expansion is already seeing substantial growth in terms of health coverage enrollment and participation. The state originally expanded Medicaid and Medicare at the height of the COVID-19pandemic…