Hi Jennifer Leugers

Please verify ACA Customization on this company and please make changes on this screen if necessary,so that the report can be re-run with latest customization.

CC: Nandkumar Prabhakar Karlekar,Sachin Hingole

Hi Jennifer Leugers

We have changed the From date as "01/01/2016" and To date as "12/31/2016" of "1095 C" report.
We have run this report. Please refer latest run for verification.

We have used existing ACA Customization for this run.Please verify the same on this company and please make changes on this screen if necessary,so that the report can be re-run with latest customization.
Also verify the Eligibility rules on 1095C report.

CC:Nandkumar Prabhakar Karlekar,Sachin Hingole

Please re-run 2016 1095C for TOC

Hi Jennifer Leugers,

We have run "2016 1095C for TOC".Please refer latest run for verification.

We have changed the Eligibility rule in the existing EIN in EIN classes Mapping under ACA Customization. Please confirm the same.

CC:Nandkumar Prabhakar Karlekar,Sachin Hingole

Hi all - the client is saying the use of 1A on their forms is incorrect. The client has a standard rate and then another rate if the employee qualifies for the wellness award. If they qualify, the cost is less than the $94.05 but if they do not, it is greater. The client also has a 7/1/16 plan year.

Two questions -
How do we fix the code so it only recognizes a 1E instead of a 1A?
How do we calculate the cost if the first six months of the year are different than the last six?

Below is from the Client's broker -

The IRS has specified that when calculating “affordability”, with the exception of wellness programs designed to prevent or reduce tobacco use, affordability must be determined assuming that employees fail to satisfy the wellness program requirements. This means that the wellness premiums that Town of Cary employees actually paid for health coverage as shown in Workterra cannot be used on Line 15 and cannot be used in calculation of the affordability. When using the non-wellness rates for Town of Cary, the employee premium is in excess of the FPL safe harbor. That is why Cary cannot use the FPL safe harbor. The ACA Team seems to have no understanding of Cary’s specifics and thus is making the error of using wellness rates in affordability calculation.

The IRS has specified that different safe harbors may be applied to the employee population only provided it is done on a uniform and consistent basis for all employees within a “reasonable category”. Reasonable categories generally include specified job categories, hourly or salaried employees, geographic location and other similar bona fide business criteria. The 1095-C forms that Workterra generated for Cary apply the FPL safe harbor based on only the wellness premium (which is the mistake addressed in item 1 above) and are applying the FPL safe harbor and the W-2 safe harbor to different employee populations based only on the amount of the premium paid and not on any “reasonable category” of bona fide business criteria.

In summary, the 1095-C forms are wrong for the reasons above and they are not acceptable to the Town of Cary or the IRS. The Town requires new 1095-C forms using the W-2 safe harbor codes and the line 15 dollar amounts specified in other emails to you. (For example, Line 14 Code 1A is changed to 1E and Cary’s employee only monthly premium contribution without any reward for wellness for Line 15 is $162.50 from January 2016 – June 2016 and $176.59 from July 2016 – December 2016.)

Additionally, Town of Cary is self-insured so they have to report on any PT employees who enrolled in coverage at any point in 2016. How can we add those individuals to the form run but not the other PT EEs with no coverage?

Hi Jennifer Leugers,

To handle this request we need data in attached format, we will push this data from back end so The line 14 and 15 will get populated as per this data. Town of Carry ACA data required.xlsx

*Point *2 :
*Aim *: Need to furnish 1095 c for PT employees who have enrolled in the ACA Plan .
No need to furnish the PT employee forms if they do not enrolled in ACA plan for any day of the 2016 year.

Solution:
We need to add enrolled in additional criteria in generic eligibility rule with OR condition for all six plan.
OR
Need to handle this from back end.

Hello Nandkumar.

Looking at the PT employees, I do not see any forms run for them. Attached are the list of PT employees who are enrolled in benefits and need forms. I check a few employees and they were issued forms in 2015.

I also looked at the Class 1 filter and no PT classes are listed.

Let me know if you have any questions.

Thanks
Kevin

Hello Nandkumar.

I filled out the excel spreadsheet the way I think you need. Please let me know what other information you need to complete. I listed what plans are used for the wellness points.

Thanks
Kevin

Hello Kevin Walker,

PT employees were not furnished form because PT class was not selected in eligibility rule in 1095C report.
I have created a new rule,selected the PT classes and added additional criteria to remove other employees in PT classes that are not mentioned in the attached list of PT employees.
I have selected this new rule on EIN classes mapping.

I have re-furnished the report. Mentioned 24 PT employees have been furnished 1095C report. Please refer latest run for verification.

Note: In report customization, plans under Medical benefit type are selected.
Plans under Retiree Dependent benefit type are not selected,but plans under this type is marked as ACA. Please confirm if the customization is correct.

We need the EE costs of the plans mentioned in the excel sheet. Town of Carry ACA data required.xlsx. Please fill the excel sheet with EE cost for the months mentioned. We need to do additional coding to overwrite the existing cost.

Let us know in case if you have any queries.

CC: Nandkumar Prabhakar Karlekar,Sachin Hingole

Hello Ramya.

Let me know if the information below will work for you.

Plan Name Jan-June 2016 July-Dec 2016
COBRA Health Plan 611.62 664.30
Health Plan 162.5 176.59
Retiree Health Plan 607.22 659.45

Thanks
Kevin

CC: Nandkumar Prabhakar KarlekarSachin HingoleJennifer Leugers

Hi all - please make sure these are run tonight.
Nandkumar Prabhakar Karlekar

The Retiree Health Plan amount should be used for the Supp Retiree plan and the two dependent Retiree plans.

ALL - I really need this done today. The client is expecting them TODAY.

Nandkumar Prabhakar Karlekar
Samir - is anyone around that can assist?

Prasanna Karlekar - I see you commented on a ticket two hours ago so just copying you on this incase you are still around and can see if anyone is around to assist.

Hi Jennifer Leugers

We will send this delivery with testing on or before your Monday morning. Please let me know your view on this.

Samir

Hi Jennifer Leugers,

As per your earlier comment, we have overwritten cost of below plans:

As mentioned in my earlier comment that,
In report customization, plans under Medical benefit type are selected.
Plans under Retiree Dependent benefit type are not selected,but plans under this type is marked as ACA.
I have selected Retiree Dependent benefit type in report customization as you have mentioned that dependent retiree plans should also get retiree plan cost.

I have furnished the report. Please refer latest run for verification.

NOTE: Only EE cost has been changed.
Analysis report also shows Employer cost.This is as per data in system.We have not made any changes in ER cost.

CC:Nandkumar Prabhakar Karlekar,Sachin Hingole,Samir

Hello Ramya Tantry,

Could you please have a 1095C form created for Joseph Cronin? He was a retiree with his spouse on the plan. Joseph passed away in November and his wife continued the coverage with the client. Currently Workterra is producing a 1095C for his wife but not for him. Please make sure a form gets included in the run for Town of Cary. The client would like a form produced for Joseph Cronin.

Line 14 = 1H
Line 16 = 2A

Part III Should be checked Jan-Oct.

Let me know if you have any questions.

Thanks
Kevin

CC: Cathleen Harrington

Hi Kevin Walker

I think, Joseph is completely retired for complete year 2016. and enrolled in self insured plan for Jan-Oct so this form need to be produced with 1G for 12 month .

Please confirm ASAP.

Hi Kevin Walker

Please refer the latest run "3/10/2017 5:11:30 AM" for "Joseph" issue fix.
we have displayed the code 1G As 1H 2A form complete year is invalid code and should not need a 1095c form.