ACA compliance
The Affordable Care Act sets rules for who you must offer coverage to, what that coverage has to look like and what you report to the IRS. We keep you on the right side of all three.
Offer the right coverage, prove it's affordable and file on time.
What does the ACA require of employers?
Applicable large employers (generally 50 or more full-time employees, including full-time equivalents) must offer affordable, minimum-value health coverage to at least 95% of full-time employees and their dependents, or risk an IRS penalty. They also file Forms 1094-C and 1095-C each year. Smaller employers aren't subject to the mandate, but still have ACA rules for the plans they choose to offer.
How we help
Are you an ALE?
We count full-time and full-time-equivalent employees month by month to confirm whether the employer mandate applies to you.
Affordability testing
We test your lowest-cost self-only option against the IRS affordability percentage using the safe harbor that fits your workforce.
Minimum value
We confirm each plan covers at least 60% of expected costs, using the carrier's or the IRS calculator.
1094-C and 1095-C reporting
We help you prepare accurate forms, codes and employee statements, and meet the IRS filing deadlines.
Measurement periods
For variable-hour staff, we help you set up look-back measurement so you know who counts as full-time.
Penalty letters
If you receive an IRS Letter 226-J, we help you understand it and respond.
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Frequently asked questions
Who counts as full-time under the ACA?
An employee averaging at least 30 hours a week, or 130 hours a month. Part-time hours are combined into full-time equivalents only to decide whether you're an applicable large employer.
What makes coverage affordable?
The employee's share of the lowest-cost self-only plan must stay below a percentage of household income that the IRS updates every year. Because employers rarely know household income, most use a safe harbor based on W-2 wages, rate of pay or the federal poverty line.
Do employers with fewer than 50 employees have ACA obligations?
They aren't subject to the employer mandate, but their plans still must meet ACA rules such as preventive-care coverage, no lifetime limits, dependent coverage to age 26 and the Summary of Benefits and Coverage.
Schedule a commitment-free meeting
Tell us what's working and what isn't. We'll review your benefits or coverage and give you an honest plan, at no cost.