Large Group, Small Group, IRS Codes

ACA, ALE’s, FTE, 6055, 6056, 1094C, 1095C
Are you and your Accountant Confused Yet?

As we prepare for the full effects of the 2016 ACA regulations to go into play, we will once again be faced with yet additional rules, regulations and potential penalties.

You will recall that in an effort to mobilize the country into assuring that “all Americans” would meet the requirement of having coverage, penalties were to be imposed on:

Individuals
*2015-Individuals who did not comply pay the greater of 2% of your household income or $325 per person ($162.50 per child under age 18). Certain exemptions may be available.
*2016-Individuals who did not comply pay the greater of 2.5% of your household income or $695 per person ($347.50 per child under age 18). Certain exemptions may be available.

Small Employers
*2015-For Groups with fewer than 50 fulltime employees, who offer coverage, must meet a number of minimum affordability requirements.

Large Group
*2015-Employers with 50 ALE’s-Applicable Large Employer (averaged at least 50 fulltime employees, including FTE fulltime equivalent employees) will be subject to 4980H penalties. Transitional relief will be available in determining ALE’s status, which will include 28 different ways, but we encourage our readers to begin tracking the hours of “every” individual who appears on your payroll as soon as possible, regardless of hours.

*2016-Small Group definition will be expanded to include Groups with fewer than 100 employees and, in addition to the 2015 requirements, those employers with 50 ALE’s-Applicable Large Employer (averaged at least 50 fulltime employees, including FTE fulltime equivalent employees) will be subject to 4980H penalties.

Important Information Reporting Filing Forms for 2016 under Section 6056 (6055 for self-insured/MEWA’s and consortiums) FOR 2015 are Forms 1094-C and 1095-C.

The Kirwan Companies, Ltd, and ACCA-Affordable Care Consulting Associates, Inc., are Employee Benefits Specialists uniquely positioned in working with physician groups for well over 30 years, and can assist you in maneuvering through the maze of ACA requirements, including making comparisons between your current Group Plan versus the use of either a MEWA (Multiple Employee Welfare Arrangement) or, if you are a group of at least 30 covered employees, we can prepare a Cost/Benefit Analysis by creating a specific Consortium plan specifically designed for your group. Members may call us directly for your free consultation and analysis.