Mahendra MungasePlease check.

Sachin HingoleMahendra MungasePlease update this on priority.

Hi Nandkumar Prabhakar Karlekar,Mahendra Mungase,

I am done with the changes requested for LHP 55 Ineligible class.
I have created an employee table which contains the employees mentioned in the excel.
However I have found that the excel shared contains Employee Name and Emp ID,but db does not contain the mentioned Emp ID's.
So I had to map the employees using their name.

I have found 43 employees in that list that are not present in Employee Table.PFA List. EmployeeListNotInDB.xls
Please confirm about these employees.
Earlier list sent through mail:1199 Employees.xls

Changes done for this request:
1. $141.29 cost for the employees belonging to 55 Ineligible class
2. 1H and 2E code for the employees mentioned in excel sheet. Replace Line 16 code to 2E where Line 14 contains 1H excluding those records if they have Line16 as 2A

@Mahendra: Please re-run the reports and verify

Regards,
Ramya Tantry

Hi Mahendra Mungase, Nandkumar Prabhakar Karlekar,

I am done with the requested changes.

Changes done are:
1. Overwrite the codes with 1H and 2E for the employees mentioned in the list excluding those records if they have 1H and 2A. Also overwrite the cost of these employees.
2. Employees with 1H and 2E should not have Covered individual part filled.
3. Removed my change of $141.29 cost for 55 Ineligible class as all plans minimum EE lowest cost is $141.29.(set on ACA CUstomization)

Mahendra Mungase : Please re-run the reports and verify.
Also verify the Plan Start Month of these employees whose codes have been overwritten.It should be 00.

Thanks,
Ramya

Abhijeet Khandagale

Please run the Process Eligibility on LHP

Thanks,
Mahendra

Mahendra Mungase Eligibility is processed.

Lena Kantemirova [~chimane@ebsbenefits.com]

Hi Elena,

We have customized the requested change and re run the 1095C.

We have verify the some employee from 55 ineligible class and observed that they are getting Line 14 1 H , Line 16 2E.
PFA for employee SSN.

Now it is available for download and review. Please find attached sheet Name - 1095C_Run_date for latest run date.

We had search the employee having spouse and child for verifying point 2 - Employees with 1H and 2E should not have Covered individual part filled. But we did not get the SSN. We will search the same , verify and attached with ticket.

Please let us know for any query

Thanks,
Mahendra

LHP forms are ready for testing

We have verified Point 2 - . Employees with 1H and 2E should not have Covered individual part filled.Observed that it is working as expected.Please find attached File - "Employee_With_Spouse_Child.xls" for Employee SSN

I just discovered an issue the "CDHP with HRA was not offered to employees until 1/1/2016. The plan start date in the system is 12/01/2015. We need to change the start date to 1/1/2016 so it does not pull on the reports

Per Debbie's request, CDH HRA Plan has been set-up to be excluded from 2015 ACA reporting.
also, with the recent changes to the 55ineligible class, we need to rerun process "update eligibility".
Please complete run eligibility portion

please coordinate eligibility update task

Eligibility has been processed.

1095c produced and ready for testing

Arlette Johnson

1095c forms completed and ready to be sent to customer for testing/review

For back end code Audit

Employee Name Location Issue
Linda Magee LHP IT Services & Bay County Employee has 15 rows on both LHP IT and Bay County Validation Reports. She also has two forms. Unsure if this is correct. Another Example is Ronda Davis Last 4 SSN 1263

The three employees below are examples of employees that are 55 Ineligible (union) but are missing a value for line 16. There are many employee with this issue across all EINs. I did find some employees that had the correct value in line 16 that were 55 Ineligible. Example: Najeeullah Abdullah
Paul Jandreau LHP IT Services Employee is 55 Ineligible should have 2E in line 16 report shows blank
Teresa Baker last 4 SSN 2766 LHP Texas MD Services Employee is 55 Ineligible should have 2E in line 16 report shows blank
Linda Martin last 4 SSN 8098 LHP Texas MD Services Employee is 55 Ineligible should have 2E in line 16 report shows blank

Ruth Dekker last 4 SSN 4722 LHP Pocatello Employee is 55 Inelgible and has 2A and 2D in line 16 and it should be 2E - Many employees in this situation

I appeared to have confused matters when auditing the forms on Saturday. I want to make sure that we are all on the same page.

The 55 Ineligible class should be handled as follows:

1. The employees on the attached spreadsheet are union employees and should have a 1H and 2E on the forms
2. The employees that are NOT on the attached list are per diem and could move in and out of 55 Ineligible. For the months they are 55 ineligible they should be 1H and blank. For the month they moved to an eligible class they should have the appropriate forms
3. I am confirming with Amber (call into her cell) what they want to do with employees that have been 55 Ineligible for all of 2015 and are not on the attached list. Do they want forms with 1H and Blank or do they not want forms produced at all.

I will send an update as soon as I hear from Amber. Elena I think we should get Dev working on #1. and #2.

We have run 1095C and 1094C on LHP. Now it is available for Download and review.

Please download below reports:

1. 1095-C LHP Management Services LLC Run Date :03/16/16 02:11 AM

2. 1095-C LHP IT Services LLC Run Date :03/16/16 02:23 AM

3. 1095-C LHP Sherman/Grayson LLC No Record Found for this Report

4. 1095-C LHP Texas MD Services Inc.Run Date :03/16/16 02:37 AM

5. 1095-C LHP Pocatello LLC Run Date :03/16/16 02:43 AM

6. 1095-C LHP Pascack Valley LLC Run Date :03/16/16 03:18 AM

7. 1095-C LHP HH/Killeen LLC Run Date :03/16/16 03:38 AM

8. 1095-C LHP Bay County LLC Run Date :03/16/16 04:43 AM

9. 1095-C LHP Montclair LLC Run Date :03/16/16 04:13 AM

Ramya Tantry

We found invalid code combination i.e. 1H 2C for one employee - SYED QADRI.

Please let us know for any query.

Surender Kumar

downloading them now

I just went in to start downloading the reports and I am not seeing the run dates above

Lena KantemirovaDebbie Kulling,Steve Allison

I am not clear with the requirement of 1H 2E ,Please you and lena discuss this and let me know so i can change the Code and furnish the 1095 c Accordingly.

I am also seeing a lot of blanks for line 16 – why would there be blanks? Example is Ashley Denney (Pocatello) – she has blanks for January to May but I think the code should be 2H.
a. This employee was eligible but waived coverage. LK: no 2H code due here because there’s no affordability to calculate – the EE waived employer coverage, so now it’s up to EE to prove to IRS, if needed, what coverage they had

CLIENT Response:

I also don’t think I agree with the theory that 2H shouldn’t be entered for the blanks such as the example below. It is my understanding that you use 2F, 2G, or 2H if line 24 code is 1B, 1C, 1D or 1E and code 2C does not apply.

2. Anyone that had an annual salary less than $17,847 should be listed as code 1F on line 14 as long as they were offered coverage. If they were 55-Ineligible and not offered coverage, then 1F wouldn’t apply. LK: This is correct, if the employer pays less than 60% of the premium for such EEs. If it’s showing otherwise – I need an example of an EE to look at to see what is driving this decision factor (i.e. salary data correct? If EE assigned to hourly or salary, etc.)

CLIENT Response:

I don’t agree with their interpretation of the regs on #2. Here is an excerpt from a Lockton legal compliance document. It is based on the 9.5%, not the 60%.
An employer satisfies Tier 2 by ensuring the offer of employee-only coverage satisfies a “minimum value” requirement of an actuarial value of at least 60 percent (we’ve referred to this as “qualifying” coverage) and is considered “affordable.” Under the ACA, employee-only coverage is considered affordable if it doesn’t cost the employee more than 9.5 percent of his or her household income.

Client's comments from yesterday are below:
From: Debbie Kulling
Sent: Wednesday, March 16, 2016 11:31 AM
To: Elena Kantemirova
Cc: Steve Allison; Chimane Rhodes; Jennifer Leugers
Subject: LHP ACA - Questions from Client

I have receive some more feedback from LHP

1. I am also seeing a lot of blanks for line 16 – why would there be blanks? Example is Ashley Denney (Pocatello) – she has blanks for January to May but I think the code should be 2H.
a. This employee was eligible but waived coverage. LK: no 2H code due here because there’s no affordability to calculate – the EE waived employer coverage, so now it’s up to EE to prove to IRS, if needed, what coverage they had
2. Anyone that had an annual salary less than $17,847 should be listed as code 1F on line 14 as long as they were offered coverage. If they were 55-Ineligible and not offered coverage, then 1F wouldn’t apply. LK: This is correct, if the employer pays less than 60% of the premium for such EEs. If it’s showing otherwise – I need an example of an EE to look at to see what is driving this decision factor (i.e. salary data correct? If EE assigned to hourly or salary, etc.)

Below is the response from LHP on the 55 Ineligible and Part time employees that did not have coverage all year.

Client Response
"If these 2 groups of employees were 55-Ineligible or Part-time all year and had no coverage at any point, then do not send them a 1095."

55 Ineligible all year – and not on the list of union people then they don’t need a form – CONFIRMED

Part Time – any part time employee that did not have any medical coverage in 2015 should not get a form - CONFIRMED

I am also seeing a lot of blanks for line 16 – why would there be blanks? Example is Ashley Denney (Pocatello) – she has blanks for January to May but I think the code should be 2H.
a. This employee was eligible but waived coverage.
This employee is in the system with Annual salary = 11232 and he is getting the Monthly premium for the employee only lowest cost plan is 141.29.
To furnish the 2H the minimum salary of this employee should be = ( (141.29 * 100)/9.5) * 12
= 17847.15
2. Anyone that had an annual salary less than $17,847 should be listed as code 1F on line 14 as long as they were offered coverage. If they were 55-Ineligible and not offered coverage, then 1F wouldn’t apply.
1F is not get calculated at the employee level. It is completely based on the Minimum value and the minimum value is getting calculated on the Standard population level.
I LHP ACA tool Configuration All Plans are marked as minimum values so 1f is not possibly get written on any of the LHP pdf.

Amber:
I am also seeing a lot of blanks for line 16 – why would there be blanks? Example is Ashley Denney (Pocatello) – she has blanks for January to May but I think the code should be 2H.
a. This employee was eligible but waived coverage.

WT ANSWER:
This employee is in the system with Annual salary = 11232 and she is getting the Monthly premium for the employee only lowest cost plan is 141.29.
To furnish the 2H the minimum salary of this employee should be = ( (141.29 * 100)/9.5) * 12
= 17847.15

So in this case there is no 2 series code that would fit so this would create a blank correctly. See attached code table combinations.

Amber:
2. Anyone that had an annual salary less than $17,847 should be listed as code 1F on line 14 as long as they were offered coverage. If they were 55-Ineligible and not offered coverage, then 1F wouldn’t apply.

IRS Instructions:
1F. Minimum essential coverage NOT providing minimum value offered to employee; employee and spouse or dependent(s); or employee, spouse and dependents.

Minimum value. A plan provides minimum value if the plan pays at least 60 percent of the costs of benefits for a standard population and provides substantial coverage of inpatient hospitalization services and physician services. An offer of coverage under a plan that fails to provide substantial coverage of inpatient hospitalization and physician services should be reported on Form 1095-C as not providing minimum value, even if an employer qualifies for the section 4980H transition rule under Notice 2014-69.

Healthcare Reform Digest:

On February 20, 2013, the United States Department of Health and Human Services released the much anticipated minimum value calculator. This tool is designed to allow both insurance carriers and employers determine plan designs that meet the Affordable Care Act’s minimum value requirement. Under the Employer Shared Responsibility provisions of the Affordable Care Act, an employer sponsored group health plan must meet certain requirements for affordability and minimum value. Minimum value means that the plan’s share of the total cost of benefits is at least 60%. This does not mean that the employer must contribute at least 60% of the cost of the premium. This requirement refers to the actual share of the total cost of a claim that the plan must pay.

Read Morehttp://www.healthcarereformdigest.com/does-my-employer-group-health-plan-meet-healthcare-reforms-minimum-value-requirements

WT Response:
1F is not get calculated at the employee level and the employee salary doesn’t factor into the calculation of minimum value. The plan is minimum value, regardless of cost to the employee based on the benefits it pays out. So a plan marked as not minimum value, would mean the plan benefits don’t meet the legal standards, and anyone who selected that plan would get a 1F regardless of the cost or its relation to the employee’s salary.

So if you agree with the above inforamtion let me know and we can request the UAT signature

We have confirmed that the part time group for LHP that should not get a 1095 for are those employees who were in 55 ineligible for the whole year and were not on the list provided for the union group. So if someone was in 55 ineligible for the while time they were employed in 2015 (so would be less than 12 months if was hired in july for example) then they should not get a form. Please let me know if there are questions.

As per Chimane's comment

Hi Rakesh Roy,

I have understand Chimane's comment but i have not understand your comment.
Can you please explain what you want to say. I am little bit confused from you comment.

Sachin Hingole,Sachin Khandge,Pradeep Kanojia [X]

Nandkumar Prabhakar KarlekarI have changed status as Reopened as per Chimane's comment.

[^LHP2EANALYSIS LHP@123.zip]

Hi Lena Kantemirova,[~chimane@ebsbenefits.com],Debbie Kulling

We have done the implementation for the Above Mention scenario and attached the Complete Analysis report for the tomorrows discussion.
I need to discuss this with you so that we all on the same page.

Now this client is ready to run ,

Chris Ellenberger

Hi Lena Kantemirova,[~chimane@ebsbenefits.com],Debbie Kulling,Chris Finocchio

Can we have quick discussion for the LHP setup. this will Help us to Complete it in one go.

Attached is the UAT for LHP LHP ACA UAT Document 3 21 16.pdf

UAT received. please proceed with next steps for fulfillment

Hi all - I've attached the updated information for these Union employees for this year.
Some of the employees are housed in WT (highlighted column) and some are not. Please let me know if you need anything else to get these folks in the next run.

Hi Jennifer Leugers,

We will be importing 158 Employees who are not in workterra from attached exel.
So as per our understanding all 337 employees are from "55 Ineligible" class so these will show 1H and 2E for all 12 months of year on PDF.

Once we get your confirmation on above points, we will furnish the PDF for LHP.

Thanks,
Sachin Hingole

shyam sharma Nandkumar Prabhakar Karlekar Rakesh Roy Ramya Tantry Mahendra Mungase

Hi Jennifer Leugers

We have imported 113 employee into the Workterra system those were not present.
We are going to create new eligibility rule for employees who belong to 55 Ineligible class and 1095C code for all these employees will be 1H *and *2E for eligible months.
Please confirm, then we will furnish 1095C for the provided employees.

Nandkumar Prabhakar Karlekar Ramya TantrySachin Hingole

Hi all - there are some employees under the 55 Ineligible class that are truly not eligible for benefits; only those on the provided list should have the 1H / 2E codes.

Hi Jennifer Leugers

We have set customized rule on the company for provided employees and generate 1H and 2E code.
Please find the attached file for code details for these employee LHP_Employee_1095C_Codes.zip .
1095C for PAUL COLLINS is not generated as he is terminated on 12/31/2014 from the provided employee list.

Password sent in mail.
Nandkumar Prabhakar KarlekarSachin Hingole Ramya Tantry

Jennifer Leugers
Do you have any inputs on same?

Thanks

Nandkumar Prabhakar KarlekarSachin HingoleRakesh Roy

Hi Jennifer Leugers

We have provided 1095C code files for the employees, we are assuming that code files provided by us is correct.

Please let us know your inputs on same.

Nandkumar Prabhakar KarlekarSachin Hingole

Hello,
Feel free to reopen in case any further action required on this. Thank you.

Hi all - we are still reviewing the feedback the client has received from the IRS.  Could you please advise why we coded the two individuals with 2D?

Shatoria Larry    Hired 3/2/5015 as 55-ineligible - Terminated 7/26/2016  1H/2D correct codes for March and April?  NOT UNION.  Why does she have a 2D

Linda Campbell Employee was 55-ineligible from date of hire 8/3/2015 employee was moved to Full time non physician on 10/4/2015.  Employee was enrolled in medical effective 1/1/2016 - current should Oct- Dec be 1E/2H since she was eligible for coverage?  In Aug and Sept 1H/2D and she was not eligible.  Her waiting period should have been Oct – Dec